{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:15:11Z","timestamp":1790021711073,"version":"4.0.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["[INV-007278 Formerly OPP1173898]"],"award-info":[{"award-number":["[INV-007278 Formerly OPP1173898]"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contraceptive implants are highly effective long-acting reversible contraceptives (LARCs), yet early discontinuation remains a major challenge globally and in Nigeria, undermining family planning (FP) goals. Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) have been trained through the IntegratE Project, to expand access to implant, but evidence on discontinuation patterns among their clients is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective descriptive study analyzed 874 routine service delivery records of women aged 15\u201349 years who sought implant removal services from trained CPs and Tier 2\/3 PPMVs between July 2023 and June 2025 across four Nigerian states (Enugu, Kaduna, Kano, and Lagos). Early discontinuation was defined as removal within two years of insertion. Descriptive statistics summarized socio-demographic and service-related characteristics, while bivariate and multivariate logistic regression identified predictors of early removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 28.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009248) of implant users who discontinued discontinued early, with similar proportions for Implanon (29.5%) and Jadelle (25.7%%). More than half (57.6%) of early discontinuers removed their implants within 12 months of insertion. Side effects (38.9%) and desire for pregnancy (37.2%) were the most reported reasons for discontinuation whether early or not, while partner disapproval accounted for 15.4%. Adjusted analysis showed women aged 35\u201339 years were less likely to discontinue early compared with those aged 25\u201329 years [Adjusted odds ratio (AOR)\u2009=\u20090.50; 95% confidence interval (CI): 0.31\u20130.80;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004]. Geographic variation was noted, with lower odds in Enugu (AOR\u2009=\u20090.53; 95% CI: 0.30\u20130.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Side effects (AOR\u2009=\u20093.01; 95% CI: 1.89\u20134.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and partner disapproval (AOR\u2009=\u20092.31; 95% CI: 1.25\u20134.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) were significant predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Almost one-third of discontinuers served by CPs and PPMVs did so early that is at less than 24 months, primarily driven by side effects and partner opposition. Strengthening counselling, managing side-effects, and engaging male partners are critical to improving continuation and advancing Nigeria's FP goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgwh.2026.1827336","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:33:54Z","timestamp":1784525634000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with early implant discontinuation among women receiving implant services from community healthcare providers (CPs\/PPMVs) in Nigeria: an analysis of routine service delivery data"],"prefix":"10.3389","volume":"7","author":[{"given":"Sikiru","family":"Baruwa","sequence":"first","affiliation":[{"name":"Research Impact, Population Council","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kolawole","family":"Oni","sequence":"additional","affiliation":[{"name":"Research Impact, Population Council","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyin O.","family":"Akomolafe","sequence":"additional","affiliation":[{"name":"Research Impact, Population Council","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeka Emmanuel","family":"Okafor","sequence":"additional","affiliation":[{"name":"IntegratE Project, Society for Family Health","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osimhen","family":"Ubuane","sequence":"additional","affiliation":[{"name":"Research Impact, Population Council","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodio","family":"Diallo","sequence":"additional","affiliation":[{"name":"Family Planning, Country Impact Team & Technical Support, Gates Foundation","place":["Seattle, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Alagbile","sequence":"additional","affiliation":[{"name":"IntegratE Project, Society for Family Health","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ladokun","sequence":"additional","affiliation":[{"name":"IntegratE Project, Society for Family Health","place":["Abuja, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"B1","volume-title":"Family Planning and the 2030 Agenda for Sustainable Development","year":"2017"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1056\/NEJMoa1110855","article-title":"Effectiveness of long-acting reversible contraception","volume":"366","author":"Winner","year":"2012","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1056\/NEJMra1510366","article-title":"Long-acting reversible contraception","volume":"376","author":"Darney","year":"2017","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.9745\/GHSP-D-12-00003","article-title":"Contraceptive implants: providing better choice to meet growing family planning demand","volume":"1","author":"Jacobstein","year":"2013","journal-title":"Glob Health Sci Pract"},{"key":"B5","volume-title":"Family Planning 2020 Final Report: Partnership in Action","year":"2021"},{"key":"B6","doi-asserted-by":"publisher","first-page":"17","DOI":"10.9745\/GHSP-D-17-00396","article-title":"Liftoff: the blossoming of contraceptive implant use in Africa","volume":"6","author":"Jacobstein","year":"2018","journal-title":"Glob Health Sci Pract"},{"key":"B7","doi-asserted-by":"crossref","first-page":"e0005174","DOI":"10.1371\/journal.pgph.0005174","article-title":"Global levels and trends in contraceptive discontinuation by method","volume":"5","author":"Ali","year":"2025","journal-title":"PLoS One Global Public Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40834-023-00250-y","article-title":"Early discontinuation of long-acting reversible contraceptives and associated factors among women discontinuing long-acting reversible contraceptives at national referral hospital, Kampala-Uganda; 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