The Contribution of Contraceptive Implants to the Contraceptive Method Mix in Jos, Nigeria: A 34-year Review

Abstract

Background: Contraceptive implants are long-acting reversible methods of contraception that have been in use in Nigeria for about 34 years. The aim of the study was to evaluate the contribution of these contraceptive implants relative to themselves and other contraceptive methods in the facility. Methodology: This was a retrospective descriptive study of over three decades of use of the various types of contraceptive implants in Jos, Nigeria. The period covered in the study was January 1985 to December 2018, a 34-year duration. The records of all clients that used the implant and clients that used other modern methods of contraception were retrieved and analyzed. The information extracted from the records of implant users included the year of introduction, year of exit if applicable and the yearly number of new method acceptors. The total yearly acceptance of other methods of modern contraception accepted by clients was also computed from the register. Results: Four contraceptive implants have been introduced into the contraceptive armamentarium in Jos up to the end of the year 2018. Norplant, Implanon classic, Jadelle and Implanon NXT were introduced in 1985, 2006, 2007 and 2016 respectively. The contraceptive implants contributed 19.1% of all new acceptors of family planning methods. Norplant was in use for 22 years, Implanon classic for 11 years, Jadelle for 12 years and Implanon NXT for 3 years. The Norplant implants accounted for 1,383 (28.2%); Implanon classic 1,805 (35.5%); Jadelle 1,591 (31.3%); and Implanon NXT 302 (5.9%). The trend of implants acceptance was multi-modal, influenced by availability and affordability. Norplant and Implanon classic have been out of use by 2018; only Jadelle and Implanon NXT were available for use by desiring clients. Conclusion: The long-acting reversible contraceptive implants have made a significant impact on the contraceptive method mix in Jos. They occupied the prestigious second position amongst the other contraceptive methods. The acceptors we believe have enjoyed good maternal health within this period in addition to the reduction in maternal mortality and morbidity. It is anticipated that this momentum is sustained and if possible improved upon for safe, effective, long-term, reversible and cost-effective family planning.