title: Twelve month follow-up of a contraceptive implant outreach service in rural Papua New Guinea.
abstract: BACKGROUND
  Poor access to contraception contributes to persistently high maternal mortality rates in Papua New Guinea (PNG). Since 2012 contraceptive implants have been provided to women in rural areas of PNG through outreach services but follow-up data in these communities on continuation and acceptability is lacking.
  
  
  OBJECTIVE
  To gain insight into women's experience with contraceptive implants by assessing the acceptability, satisfaction, 12 month continuation rates and efficacy of contraceptive implants among women in rural PNG.
  
  
  METHODS
  We undertook a cross-sectional survey of women in two rural provinces who had received a contraceptive implant at least 12 months prior using a structured questionnaire. We sought information on device continuation rates, satisfaction scores, side effects and failure rates.
  
  
  RESULTS
  Of the 860 women surveyed, 97% (n = 836) still had the device in situ after 12 months and 92% (n = 793) were very happy with it. Seventy-six percent of women (n = 654) reported no side effects. Irregular bleeding was the most commonly reported side effect (n = 178, 20.6%) but only 7% (n = 13) said the bleeding was bothersome. Documented failure rates were 0.8% although pregnancy at the time of insertion could not be excluded in any of these cases.
  
  
  CONCLUSIONS
  Twelve month implant follow-up data in this study showed high continuation rates and high levels of satisfaction among a rural population in PNG. Implants have the potential to lower maternal morbidity and mortality and simultaneously address the unmet need for contraception in these communities.
authors.affiliation: Department of Obstetrics and Gynaecology, John Hunter Hospital, Newcastle, New South Wales, Australia.|School of Public Health, Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Sarika
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine and Health Sciences, UPNG and The Port Moresby General Hospital, Port Moresby, Papua New Guinea.
authors.forename: Glen
authors.initials: G
authors.lastname: Mola
authors.affiliation: Discipline of Obstetrics and Gynaecology and Neonatology, Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Philippa
authors.initials: P
authors.lastname: Ramsay
authors.affiliation: Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Jenkins
authors.affiliation: 'Spacim-Pikinini Organisation', Rotary Australia World Community Services, Sydney, New South Wales, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Stein
authors.affiliation: Department of Obstetrics, Modilon Hospital, Madang, Papua New Guinea.
authors.forename: John
authors.initials: J
authors.lastname: Bolnga
authors.affiliation: Discipline of Obstetrics and Gynaecology and Neonatology, Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D008796:Metrorrhagia / Q000139:chemically induced; D008875:Middle Aged; D010219:Papua New Guinea; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011247:Pregnancy; D018873:Pregnancy Rate; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D016912:Levonorgestrel
keywords: contraceptive implant; maternal mortality; reproductive health