Method shifting from long to short term contraceptives and its associated factors among reproductive age women, northwest Ethiopia.

Background: Even if long term contraceptives are more effective, efficient and tolerable choices, method shifting from long to short term contraceptives continued as a global challenge including Ethiopia. There is limited evidence on the proportion and factors associated with method shifting from long term to short term contraceptives in the country, specifically in the study area. Therefore, this study assessed the proportion and associated factors of method shifting from long term to short term contraceptives in Gondar city administration, northwest Ethiopia.

Methods: Institution based cross-sectional study was conducted from February to June 2018 among reproductive age women who were long term contraceptive users. A total of 407 women of reproductive age were selected using systematic random sampling technique. Data were entered through Epi Info version 3.5.3 and analyzed using SPSS version 20. Bivariable and multivariable logistic regression analyses were employed to investigate factors associated with method shifting. Adjusted Odds Ratio with the corresponding 95% confidence intervals were used to show the presence and strength of association. Variables with P-value of < 0.05 in the multivariable model were considered to have statistically significant association with method shifting.

Results: The overall proportion of method shifting from long to short term contraceptives was 48.5% [CI: 43.8, 53.3]. Having secondary level educational status [AOR = 0.18, CI = 0.07, 0.51], using long acting contraceptives for limiting purposes [AOR = 0.26, CI = 0.11, 0.60], and having enough counseling on long acting contraceptives during ANC visits [AOR = 0.20, CI = 0.08, 0.50] were factors negatively associated with method shifting, while receiving information about long acting contraceptives from colleague [AOR = 6.67, CI = 1.89, 23.52] was positively associated with method shifting.

Conclusion: The proportion of method shifting from long to short term contraceptives was 48.5%. Women's educational level, source of information, the aim behind using long acting contraceptives, and counseling adequacy were the main factors associated with method shifting. Therefore, health care providers better consider women's educational level, provision of accurate information and adequate counseling are crucial in the provision of long acting contraceptive methods.