Determinants of Contraceptive Discontinuation Among Sexually Active Women in Nigeria: A Systematic Review
1
Global Health and Infectious Diseases Institute, Nasarawa State University, Keffi, Nigeria
2
Africa Centre for Disease Control and Prevention, Addis-Ababa, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Contraceptive use is critical for improving reproductive health and reducing unintended pregnancies, yet many women discontinue use despite ongoing need. In Nigeria, the total fertility rate remains high at 4.8 children per woman, while modern contraceptive prevalence among women of reproductive age is only 17–20%, highlighting persistent gaps in family planning. This systematic review aimed to synthesize evidence on the prevalence, patterns, and determinants of contraceptive discontinuation among Nigerian women.
METHODS:
A systematic review was conducted focusing on studies from Nigeria involving sexually active women aged 15–49 years who had previously used contraceptives. Multiple databases (Google Scholar and PubMed) were searched using keywords for family planning, discontinuation, and Nigeria. Eligible observational, qualitative, and mixed-methods studies were screened and selected using the PRISMA framework. Data extraction included prevalence, method-specific discontinuation, and reasons for cessation. After screening 12,768 records and removing duplicates, 48 studies were included in the review.
RESULTS:
Discontinuation rates varied by method type. Condoms were discontinued due to discomfort, or misconceptions, with 12-month discontinuation rates around 17–18%. Oral contraceptives were discontinued within the first 12 months by 21–59% of users, largely due to side effects, daily regimen demands, and personal fertility intentions. Injectables showed discontinuation rates of 19.8–53.3%, mostly within the first 3–6 months, driven by side effects and pregnancy desire. Long-acting reversible contraceptives, including implants and intrauterine devices, had lower discontinuation rates (7%–42.9% at 12 months), though early discontinuation was associated with menstrual irregularities, pregnancy desire, or method-specific side effects. Key determinants of discontinuation included side effects, fertility desires, spousal opposition, cultural or religious beliefs, and poor-quality counselling.
CONCLUSIONS:
Contraceptive discontinuation in Nigeria undermines family planning effectiveness and contributes to high fertility. Policymakers should strengthen national counseling standards and ensure method availability. Donors should invest in provider training, follow-up systems, and commodity supply.
Contraceptive use is critical for improving reproductive health and reducing unintended pregnancies, yet many women discontinue use despite ongoing need. In Nigeria, the total fertility rate remains high at 4.8 children per woman, while modern contraceptive prevalence among women of reproductive age is only 17–20%, highlighting persistent gaps in family planning. This systematic review aimed to synthesize evidence on the prevalence, patterns, and determinants of contraceptive discontinuation among Nigerian women.
METHODS:
A systematic review was conducted focusing on studies from Nigeria involving sexually active women aged 15–49 years who had previously used contraceptives. Multiple databases (Google Scholar and PubMed) were searched using keywords for family planning, discontinuation, and Nigeria. Eligible observational, qualitative, and mixed-methods studies were screened and selected using the PRISMA framework. Data extraction included prevalence, method-specific discontinuation, and reasons for cessation. After screening 12,768 records and removing duplicates, 48 studies were included in the review.
RESULTS:
Discontinuation rates varied by method type. Condoms were discontinued due to discomfort, or misconceptions, with 12-month discontinuation rates around 17–18%. Oral contraceptives were discontinued within the first 12 months by 21–59% of users, largely due to side effects, daily regimen demands, and personal fertility intentions. Injectables showed discontinuation rates of 19.8–53.3%, mostly within the first 3–6 months, driven by side effects and pregnancy desire. Long-acting reversible contraceptives, including implants and intrauterine devices, had lower discontinuation rates (7%–42.9% at 12 months), though early discontinuation was associated with menstrual irregularities, pregnancy desire, or method-specific side effects. Key determinants of discontinuation included side effects, fertility desires, spousal opposition, cultural or religious beliefs, and poor-quality counselling.
CONCLUSIONS:
Contraceptive discontinuation in Nigeria undermines family planning effectiveness and contributes to high fertility. Policymakers should strengthen national counseling standards and ensure method availability. Donors should invest in provider training, follow-up systems, and commodity supply.
| eISSN: | 2654-1459 |
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