Rationale and disparity of contraceptive discontinuation in Bangladesh

Contraceptive discontinuation of a couple has become a more progressive important determinant of fertility in Bangladesh. Contraceptive prevalence rate has steadily grown from 8 percent of currently married women in 1975 to 56 percent in 2007 whereas TFR has declined from 6.3 births per woman in 1975 to 2.7 births per woman in 2007. Thus, the study of contraceptive discontinuation of a couple has significant influence on fertility in Bangladesh. This study is based on calendar data extracted from the 2004 Bangladesh Demographic and Health Survey. Life table techniques have been employed to find out the contraceptive discontinuation rates at different durations of use and median duration of use for different methods. The result exhibits that almost half of women who initiate the use of a method discontinue it within a year and nearly two-thirds discontinue within two years. The IUD has the lowest discontinuation rates, while condom has the highest followed by injections, pills, withdrawal and periodic abstinence. Differentials in discontinuation rates have also been examined for different contraceptive methods. Multiple-decrement life table have been applied to generate net discontinuation rates for each reason in the presence of other competing reasons for discontinuation. This net discontinuation rates for each reason indicates that side effects is the major cause of discontinuation for the pill, IUD and injections among modern methods. The method related reason is the important cause for the discontinuation of traditional methods. Reason specific discontinuation varied according to different socio-demographic covariates. The study will help policy makers to understand the success and quality of the family planning program and services.