How acceptable are injectable contraceptives? Experiences of users and health care providers in India

This paper examines women’s experiences of using injectable contraception (IC) from the perspectives of women and health care providers, and sheds light on the feasibility and acceptability of making IC widely available in India. The study was undertaken in 27 selected facilities of 4 NGOs in 5 states. Using a retrospective study design, 375 married women were interviewed who had initiated IC use in 12-21 months before the interview. In-depth interviews were conducted among 16 health care providers. Findings, based on lifetable analysis, indicate that just 23% of the women continued to use ICs at 12 months. Reasons for discontinuation centred on the side-effects experienced, largely menstrual disturbances. Counselling was not comprehensive for most women. Multivariate analysis suggests that women who had continued using ICs for at least 12 months tended to be younger, educated and multiparous. Notably, continuation rates were also higher among women who had experienced fewer side-effects and were provided good quality of care. In-depth interviews with health care providers corroborated many of these findings. Findings suggest that although continuation rates are low, a considerable proportion of women find IC an acceptable method. With appropriate counselling, it is possible to offer this method more widely in the RCH programme.