Changes in Contraceptive Discontinuation in Egypt Between 2008 and 2014

A recent rise in the contraceptive discontinuation rate in Egypt from 25.9% in 2008 to 30.1% in 2014 was reported by the Demographic and Health Survey (EDHS). This paper’s objective is to examine the dynamics behind the increase in the contraceptive discontinuation rate and highlight conditions that should be met to prevent any further increase. Life tables net rates of discontinuation were applied to the calendar data for both EDHS2008 and 2014. Discontinuation, switching and failure rates were calculated by reason, and for the three main contraceptive methods. The paper also examines to what extent has the act of discontinuing a contraceptive method left a user at risk of an unintended pregnancy. The results show that although the discontinuation rate increased for the three main contraceptive methods, the discontinuation rate due to “method/service related reasons” has remained constant at about 18%, while “reduced need” has significantly increased from 8% to 12%. About half of the discontinued segments due to “service quality” switch to another contraceptive method. The results indicate an improvement in switching behavior in Egypt, However, the majority of IUD switchers move to a less effective method. Discontinuation due to method failure increased from 2.9% to 4.3%. This increase varied according to each method. The findings suggest that the National Family Planning Program should continue to exert effort to improve the quality of service and provide better counselling to decrease method failure rates and discontinuation. Counseling regarding side effects is still an issue that is likely to provoke discontinuation. In addition, the results stress the need for more advocacy efforts that highlights the benefits of small families. Increases in the level of wanted fertility pose a great challenge facing the realization of the national population goals.