title: Contraceptive Adoption, Discontinuation, and Switching among Postpartum Women in Nairobi's Urban Slums.
abstract: Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods.
authors.affiliation: Associate Research Scientist, African Population and Health Research Center, Population Dynamics and Reproductive Health Program, APHRC Campus, 2nd Floor Manga Close, Off Kirawa Road, Nairobi, Kenya. jmumah@aphrc.org.
authors.forename: Joyce N
authors.initials: JN
authors.lastname: Mumah
authors.affiliation: Research Fellow, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Machiyama
authors.affiliation: Data Analyst, African Population and Health Research Center, Population Dynamics and Reproductive Health Program, APHRC Campus, 2nd Floor Manga Close, Off Kirawa Road, Nairobi, Kenya.
authors.forename: Michael
authors.initials: M
authors.lastname: Mutua
authors.affiliation: Research Scientist, African Population and Health Research Center, Population Dynamics and Reproductive Health Program, APHRC Campus, 2nd Floor Manga Close, Off Kirawa Road, Nairobi, Kenya.
authors.forename: Caroline W
authors.initials: CW
authors.lastname: Kabiru
authors.affiliation: Emeritus Professor of Medical Demography, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Cleland
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004343:Drug Implants; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D007630:Kenya; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction; D049590:Postpartum Period; D011204:Poverty Areas; D012746:Sexual Abstinence; D013245:Sterilization, Reproductive / Q000706:statistics & numerical data*; D014505:Urban Population; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003276:Contraceptives, Oral; D004343:Drug Implants