Experts say changes in motivation to prevent pregnancy influence contraceptive continuation in women who receive family planning services from community pharmacists and patent and proprietary medicine vendors (PPMVs) in Nigeria.
In a longitudinal study, the researchers that observed women’s motivation to avoid pregnancy at two-time points, and how changes in motivation influence contraceptive continuation, said family planning providers, including private sector pharmacists and drug shop owners, should continuously check in with women about their motivations around pregnancy to support continuation among those who wish to avoid pregnancy.
The researchers evaluated data from the IntegratE project, which seeks to expand access to family planning (FP) in Nigeria through community pharmacies and drug shops. 491 women were interviewed within 10 days after receiving a family planning service (counselling, referral or FP method) from these sources and again approximately 9 months later.
IntegratE is a 4-year project (2017–2021) that collaborated with the Federal Ministry of Health to pilot a three-tiered accreditation system for PPMVs.
As part of the Nigerian Federal Ministry of Health’s strategy to expand access to FP, they are exploring task sharing certain FP services to private sector community pharmacists (CPs) and PPMVs.
In the study, the dependent variable was contraceptive continuation at the follow-up interview. A categorical independent variable was used to represent changes in motivation to avoid pregnancy from enrollment to the follow-up interview.
The 2022 study, in the journal, Reproductive Health, noted that 89% of women continued using contraception approximately 9 months after the enrollment interview.
In addition, women who remained highly motivated to avoid pregnancy were 2.5 times more likely to continue using contraception, compared to women who became more motivated. Women who became less motivated were 64% less likely to continue using contraception compared to those who became more motivated.
Women who reported a decrease in motivation to prevent pregnancy were 70% less likely to be using contraception compared to those who reported an increase. Also, women who did not experience side effects at follow-up were 2 times more likely to be using contraception.
According to the researchers: “Our results also suggest that it is important for healthcare providers to continually ask their clients about their pregnancy motivations due to the association with continuation. By continually checking in with women, providers can assist their clients to choose the most appropriate method or switch to a different method if, and when, their life and motivations change.
“For women who become more or less motivated, discussing the possibility of switching to a longer/shorting acting method may be appropriate, especially if the woman is not happy or satisfied with her current method.”
Contraceptive discontinuation contributes to approximately one-third of unmet needs globally. Given that discontinuation contributes to a sizable portion of unmet needs, numerous studies have explored reasons associated with discontinuation among women who wish to avoid pregnancy.