Why Do Women Discontinue a Modern Method of Contraception? A Comparative Analysis of the Last Two DHS in Pakistan Using Contraceptive Calendar

Muhammad Wazir, United Nations Population Fund (UNFPA)
Muhammad Ali Raza
Yilma Alazar, United National Population Fund

Pakistan experienced a slow decline in fertility since the onset of the 21st century, despite a substantial decline during the 1990s. Only a quarter of women have access to modern contraceptive methods, a figure that has remained static between 2012 and 2017. Pakistan is one of the countries with a high rate of contraceptive discontinuation; three out of every ten contraceptive users (30%) discontinued use within 12 months, a minor decrease from 37% in 2012-13. Although, the reproductive calendar from the last two rounds of Pakistan Demographic & Health Survey (2017-18 and 2012-13) provides an opportunity to study the dynamics of contraceptive discontinuation in Pakistan at national and subnational level, however, it has not analyzed. The analysis unit of this study is the segment of contraceptive use, which refers to the continuous use of a contraceptive method. We apply Gompertz proportional hazards model to the dichotomous variable. First-year discontinuation rate for all methods was high, primarily because of discontinuation of short-term methods. The contraceptive discontinuation rate while in need was also considerably high, with health concerns/fear of side effects cited as the most common reason for discontinuation. This study’s findings highly recommends that the inclusion of Pakistan FP Program’s goal.

Keywords: Family Planning and Contraception, Decomposition analysis, Data and Methods

See paper.