Pill Discontinuation and Its Aftermath in 18 Developing Countries

Mohamed M. Ali, World Health Organization (WHO)

In most developing countries the pill is the most commonly used reversible method of contraception. Yet typically about 30% of women abandon the method within 12 months for reasons that imply dissatisfaction with the method. What happens thereafter this has considerable significance for the incidence of unwanted pregnancies, induced abortion and fertility. This paper uses DHS contraceptive calendar data from 18 countries to assess, in detail, method-specific switching probabilities following pill discontinuation and their correlates. Within 3 months, the percentage of women switching to another modern method ranged from 18% to 57% with a mean of 35%. Switching to a traditional method ranged from less than 5% in 4 countries to over 30% in 4 other countries, with a mean of 18%. Two individual correlates of switching (women’s education and fertility preference) are assessed and the paper ends with an examination of the link between program characteristics and switching.