dc.contributor.author | Orang'o, Elkanah O | |
dc.date.accessioned | 2013-06-10T06:49:53Z | |
dc.date.issued | 2005-02 | |
dc.identifier.citation | Degree of Master of Medicine in Obstetrics and Gynaecology | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/30388 | |
dc.description | Thesis submitted in part for the fulfillment of Degree of Master of Medicine
in obstetrics and gyanaecology
of the
University of Nairobi | en |
dc.description.abstract | Premature removal and discontinuation of contraceptive implants (Norplant) is a cause of
a sizeable national expenditure in Kenya. Understanding the factors that influence the
decision to remove the implants and being able to predict which users are likely to elect
discontinuation prematurely could provide useful information for counselling patients as
they are considering contraceptive implants so that potentially enormous long-term
savings could be achieved.
The objective of the study was to determine reasons for removal and discontinuation of
Norplant contraceptive implants among users as seen at the Moi Teaching and Referral
Hospital's family welfare clinic.
Study design
This was a cross-section descriptive survey that was carried out at the Moi Teaching and
Referral Hospital's family welfare clinic between 1st march 2003 and 28th February 2004
both days inclusive.
A structured questionnaire was administered to eligible clients after a written consent had
been obtained. Other details were obtained from clinical records.
A total of 147 eligible clients were enrolled in this study. Most of the clients seen were
young, of low parity and in a married relationship. Over 70% of them were below 35
years of age. All the clients had attained at least primary school level of education, with
57.1% having attained secondary education and only 1.4-% College/ University. 83% of
the clients' spouses knew that they were using Norplant contraceptive and supported them
in doing so. Majority of the clients were of low to moderate income bracket, with 81.7
earning less than 10,000 Ksh per month as combined household income.
The mean duration ofNorplant contraceptive implant use was 23 months.
There was no major immediate complication following Norplant contraceptive implant
insertion in 98.6% of the clients. Most of the clients, 78.9%, interviewed found Norplant
to be effective and reliable.
The leading reason for Norplant contraceptive implant removal was found to be
menstrual irregularities and this accounted for 41.5%. Other reasons included desire for
pregnancy 22.5%, headache 9.5%, weight changes 6.1%, pain and numbness of the hand
6.8%, chest pain 3.4%, palpitations 4.8%, and backache 2.7%, and skin changes 2.7%.
The operative procedure for Norplant contraceptive implant removal was relatively easy,
simple and had little morbidity. The mean duration of the operation procedure was 7.53
minutes. Most of the clients preferred to switch immediately to another method of
contraception after Norplant removal. The most popular method of choice was oral
contraceptive pills in 22.1% followed by injectable methods (Depo provera) in 15%.
Despite their desire to have Norplant implants removed, 34% of the clients would still
recommend this method to a friend.
It was impressive to note that 98.0% of the clients understood that Norplant contraceptive
method prevented unplanned pregnancies but not sexually transmitted diseases including
HIV/AIDS. | en |
dc.language.iso | en | en |
dc.title | Case records and commentaries in Obstetrics and Gynaecology | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.embargo.terms | 6 months | en |
local.publisher | Department of Obstetrics and Gynaecology | en |