Experiences of women using etonogestrel contraceptive implant and reasons for removal in Tshwane District, Gauteng
Date
2021
Authors
Bunu, Noluthando
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Abstract
Etonogestrel, also called Implanon, is one of the new contraceptive implant
methods that is highly effective and convenient. Regardless of several benefits,
women still access health facilities to request removal of this contraceptive
implant before the expiry date. South Africa reported early removals of Implanon
by users after a successful launch in the Public sector in 2014, with high uptake.
Tshwane district in
Gauteng, specifically, experienced high rates of Implanon removal before expiry
date. However, no study has been conducted in Tshwane District to assess
implementation of the new contraceptive method and focuses on the experiences
of the users and the reasons for early removal. Therefore, the aim of the study
was to describe women’s experiences of using the etonogestrel contraceptive
implant and to determine the reasons for early removal of the implant among
women in Tshwane District.
This was a qualitative research study using in depth interviews to collect data from
22 women aged between 18 to 49 years. These women had accessed primary
health care services in Tshwane District for removal of the Implanon and
voluntarily consented to participate in the study. An interview guide was used to
elicit the information and data was analysed using thematic content analysis.
The study revealed that women chose the contraceptive implant because it was
convenient and effective. Regardless of the benefits of Implanon, women decided
to remove the contraceptive implant before the expiry date due to intolerable side
effects such as irregular bleeding, dizziness, headache, weight gain or weight
loss. The study also established gaps in counselling services rendered by
professional nurses, management of side effects and follow up thereafter, which
is similar to what was found in other studies.
There is therefore a need for health care providers to be trained adequately on
counselling, management of side effects and further follow up to help improve the
sustained use of this contraceptive implant by women. Additionally, clear
guidance on the post insertion follow up process, counselling and management
of side effects specific to the etonogestrel contraceptive implant should be
incorporated in the training. This is currently not outlined in the National
Contraceptive Clinical guidelines.
Description
A research report submitted in partial fulfilment of the requirements for the degree of Master of Public Health (Maternal and Child Health) to the Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, 2021