Presentation (CTI)

OBJECTIVES: Hormonal implants are highly effective long-acting reversible contraceptive (LARC) methods, yet their uptake in many low- and middle-income countries remains low. Early discontinuation of implants undermines their effectiveness and may reflect gaps in counseling and follow-up services.To determine the uptake of subdermal hormonal implants and identify factors associated with early removal among women attending a family planning clinic in a tertiary hospital in West Africa between January 2018 and December 2020.
METHODS: This was a retrospective descriptive study based on data from Lagos State University Teaching Hospital’s family planning clinic. Information was extracted using a structured proforma and analyzed using SPSS version 20. Pearson’s Chi-square test was applied to evaluate associations, with statistical significance set at p < 0.05.
RESULTS: Out of 3,784 women who accessed contraception during the study period, 698 (18%) opted for hormonal implants. Of these, 45% had early removal. Common reasons included the desire to conceive (38%), side effects such as menstrual irregularities and weight gain (35%), and inadequate counseling (21%). Early removal was significantly associated with lower educational attainment, nulliparity, and suboptimal pre-insertion counseling (p < 0.05).
CONCLUSIONS: Despite the proven efficacy of hormonal implants, their uptake remains modest, and early removal is prevalent. These findings highlight the need for improved counseling, individualized contraceptive care, and better management of side effects to enhance continuation rates. In Nigeria, where the unmet need for contraception remains high and fertility rates are elevated (NDHS 2018: 5.3 children per woman), strengthening family planning services is imperative to achieving national reproductive health goals.