Nwe Tin, Khaing, Thae Maung Maung, and Thiri Win. 2019. Factors that Affect the Discontinuation of Family Planning Methods in Myanmar: Analysis of the 2015-16 Myanmar Demographic and Health Survey. DHS Working Paper No. 145. Rockville, Maryland, USA: ICF.
Access to family planning contributes up to a 44% reduction in maternal deaths and a 21% reduction in deaths of children under age 5. Since the majority of unplanned pregnancies and abortions occur in women who were either not using birth control or not using it consistently, greater access to contraception and more consistent use of contraception are crucial in the reduction of unplanned pregnancies and abortions. This study aims to determine the most common types of contraceptives that have been discontinued, the reasons for discontinuation, and factors that affect the discontinuation in Myanmar.
This study was a secondary data analysis of the 2015-16 Myanmar Demographic Health Survey. The study included women age 15-49 who used contraceptive methods within the 5 years before the survey. The dependent variable in the study was the number of women age 15-49 who used contraception in 5 years before the survey, and discontinued within 12 months after beginning its use. To describe the dynamic of contraceptive use, we used the Demographic and Health Survey calendar file that collected information about reproduction and contraception. Multivariable logistic regression was used to identify the predictors of discontinuation of contraceptives.
The first-year discontinuation rate for all contraceptive methods was 39.1%. The discontinuation rates for short-term methods were remarkably high (43% for pills and 42% for injectables), while the rate for long-term methods was very low (7.3% for intrauterine devices). Discontinuation by those who in need of contraception was high (54.6%), although 27.6% of those women switched to other modern methods. After controlling for other factors with multivariable logistic regression, the predictors for contraceptive discontinuation were a woman’s age, location (state/region), wealth index, and number of births within 5 years.
High rates of discontinuation by women in need of family planning are very alarming given the programs designed to reduce the unmet need for family planning and prevent unwanted pregnancies in Myanmar. Family planning programs must ensure timely, informed method-switching by women who discontinued contraception, strengthen the availability and accessibility of long-term contraceptive methods, and encourage proper counseling that ensures clients’ informed and voluntary choice of family planning services.