Three outcome variables were used in this analysis: current use of a modern contraceptive method, method mix and contraceptive discontinuation resulting in unmet need.
This index, however, is not useful in answering the following question: What is the projected contribution of current users of modern methods to unmet need in the future if these users experience the current high contraceptive discontinuation rates?
Four variables were considered to explain country-level variations in the relevant discontinuation index: the number of available methods, the type or composition of available methods, the country's Human Development Index (HDI) and its region.
There are many factors that contribute to discontinuation of therapy, including loss of effectiveness, immunogenicity, drug-related toxicity, infusion and systemic allergic reactions, and development of comorbidity [13, 19, 20].
Gomez-Reino and colleagues studied the rates and reasons for discontinuation of TNF inhibitors over the past decade (2000-2009).
Universal screening for latent TB infection only became widespread once the risk of TB reactivation had been identified and might have led to higher rates of discontinuation due to TB reactivation in the early years of TNF inhibitor therapy.
Pregnancies within the three years prior to and at the time of the survey (April 1999-November 2002) were classified as either "intended," "mistimed," or "unwanted." The key independent variable was whether the woman had used contraception within 12 months of the pregnancy and, for those who had used it, the reason for discontinuation (either to get pregnant or for another reason).
Any program should include an increased effort to reduce contraceptive failure and better address the side effects and the health concerns that women have that can lead to discontinuation. Non-users who want to delay or limit births should also be identified and targeted for outreach in order to reduce unintended pregnancies.
Unintended pregnancies are the consequence of multiple factors including non-use of contraception among women who do not want to get pregnant, contraceptive failure among users of contraception, and contraceptive discontinuation, that is, the starting and stopping of contraceptive use.
RESULTS: The proportion of births reported as intended following contraceptive failure ranged from 16% in Bangladesh to 54% in Kazakhstan, and the proportion reported as intended following discontinuation for reasons other than a desire for pregnancy ranged from 37% in Kenya to 51% in Kazakhstan.
CONCLUSION: These findings suggest that underlying variation in the motivation to avoid pregnancy is an important factor in contraceptive discontinuation.
(1), (2) Analyses of survey data have demonstrated that contraceptive discontinuation is common.