Risk of Discontinuance in Contraceptive Uptake Among Kenya Women:  A Survival Analysis Using the Cox Proportional Hazard Model

Samuel Baffoe; Arori O. Wilfred; Cynthia Linet Anyago

Risk of Discontinuance in Contraceptive Uptake Among Kenya Women: A Survival Analysis Using the Cox Proportional Hazard Model

Author(s)	Samuel Baffoe, Arori O. Wilfred, Cynthia Linet Anyago
Country	Kenya
Abstract	A problem of equal importance is the substantial challenge posed by the discontinuance of contraceptive use in family planning programs, particularly for developing countries such as Kenya. Investigating the determinants of contraceptive discontinuation using demographic factors can provide insights to enhance the efficacy of family planning. Using data from the Performance Monitoring for Action (PMA) survey, this study examined the demographic and contraceptive method-related covariates associated with the risk of discontinuation of contraception among Kenyan women. The study employed Cox proportional hazards models to analyze sampled data of Kenyan women from the PMA survey. Two separate models were used: a standard model which included demographic characteristics with a baseline contraceptive variable (Ever use contraceptive) and an extended model showing how specific contraceptive methods impact the likelihood of the risk of discontinuing contraception. Older age (Coefficient of -0.268 with a hazard ratio of 0.765) was associated with a decreased risk of contraceptive discontinuation. At the same time, women with higher educational levels (Coefficient of 0.015, with a hazard ratio of 1.015) were related to an elevated hazard and were more likely to discontinue their current method of contraception. The extended model showed that subcutaneous injectable contraceptives (Coefficient of -2.040 with a hazard ratio of 0.130) and male condoms (Coefficient of -1.137 with a hazard ratio of 0.321) were conditionally related to a significantly decreased hazard of discontinuation. The results highlight the importance of contraception choice and the significance of age and education in maintaining continuous contraception. To support Kenyan women in maintaining continuous contraception in achieving their reproductive health goals comprehensive education on emergency contraception and the provision of long-acting reversible contraceptives should be provided by health and family planning organizations. There is a call for a longitudinal study to offer an understanding of the dynamic behavior of contraception over time and the need for time-varying analyses to capture the evolving nature of contraception and its discontinuation.
Keywords	Cox proportional hazards models, contraceptive discontinuation, family planning, Performance Monitoring for Action (PMA)
Field	Mathematics > Statistics
Published In	Volume 6, Issue 6, November-December 2024
Published On	2024-11-06
Cite This	Risk of Discontinuance in Contraceptive Uptake Among Kenya Women: A Survival Analysis Using the Cox Proportional Hazard Model - Samuel Baffoe, Arori O. Wilfred, Cynthia Linet Anyago - IJFMR Volume 6, Issue 6, November-December 2024.

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Risk of Discontinuance in Contraceptive Uptake Among Kenya Women: A Survival Analysis Using the Cox Proportional Hazard Model

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