More than one in five women in Ethiopia who start a contraceptive method stop using it within twelve months, according to a new analysis of nationally representative survey data published in Contraception and Reproductive Medicine. The study, based on the 2023 Performance Monitoring for Action (PMA) cross-sectional survey, reports a 12-month contraceptive discontinuation rate of 22.39 percent, with a 95 percent confidence interval of 19.98 to 25.00 percent.
The research team, led by Tigist Kifle Tsegaw and colleagues, drew on a retrospective 24-month contraceptive calendar included in the 2023 Ethiopia PMA survey. Their analysis focused on discontinuation occurring within 12 months of method initiation. In total, 1,552 women contributed data, a figure that weighted to 1,590, and these women accounted for 1,756 contraceptive-use episodes, weighted to 1,816. All statistical analyses were carried out in Stata 17.
Because the survey design involves women clustered within sampling units, the investigators used multilevel binary logistic regression to identify factors independently associated with discontinuation. They calculated the intraclass correlation coefficient (ICC) to determine whether multilevel modeling was warranted, and the resulting null model showed substantial between-woman variation, with an ICC of 50.51 percent. Variables with p-values below 0.25 in bivariable analysis were carried forward into the multivariable model, and p-values below 0.05 were treated as statistically significant. Model comparison was performed using the log-likelihood ratio.
Three factors emerged as significantly associated with discontinuation in the fixed-effects model. Women using long-acting contraceptive methods were markedly less likely to discontinue, with an adjusted odds ratio of 0.16 (95 percent CI: 0.08 to 0.31), meaning long-acting users had substantially lower odds of stopping within a year compared with users of other methods. Being multiparous was also protective, with an adjusted odds ratio of 0.20 (95 percent CI: 0.10 to 0.42).
In contrast, one reproductive characteristic was linked to higher discontinuation. Women who reported experiencing reproductive coercion had more than double the odds of discontinuing their method, with an adjusted odds ratio of 2.18 (95 percent CI: 1.17 to 4.05). This finding points to the role of autonomy and control in contraceptive decision-making, an area the authors highlight in their interpretation of the results.
The highest discontinuation among method types was observed among injectable users, according to the study results.
The authors frame contraceptive discontinuation as a continuing public health concern in Ethiopia. Discontinuation increases the risk of unintended pregnancies and related adverse reproductive health outcomes, and despite increased use of modern contraceptive methods in the country, it remains a major challenge. The study was motivated by a gap in updated evidence on discontinuation rates and their determinants using recent, nationally representative data.
Based on their findings, the researchers conclude that strengthening informed contraceptive choice and improving women’s reproductive autonomy may support contraceptive continuation. They note that both contraceptive method type and reproductive characteristics were associated with discontinuation in their analysis. As a cross-sectional survey analysis relying on retrospective calendar data, the study identifies associations rather than causal effects, and the reported estimates reflect the 2023 PMA survey population of reproductive-age women in Ethiopia.
Subject of Research: Contraceptive discontinuation rates and associated factors among reproductive-age women in Ethiopia using 2023 PMA survey data
Article Title: Contraceptive discontinuation rate and associated factors among reproductive-age women in Ethiopia: evidence from the 2023 performance monitoring for action cross-sectional survey
Article References: Tsegaw, T. K., Alemayehu, M. A., Tadese, Z. B., Alemu, E. A., Arage, F. G., Taye, E. A., Kelkay, J. M., & Gessese, R. T. (2026). Contraceptive discontinuation rate and associated factors among reproductive-age women in Ethiopia: evidence from the 2023 performance monitoring for action cross-sectional survey. Contraception and Reproductive Medicine. https://doi.org/10.1186/s40834-026-00481-9
Image Credits: AI Generated
DOI: 10.1186/s40834-026-00481-9
Keywords: contraceptive discontinuation, Ethiopia, PMA survey, reproductive health, family planning, long-acting contraceptives, reproductive coercion, multiparity, multilevel analysis, cross-sectional survey, unintended pregnancy, women's health
News Source: Ophelia Keating. (October 28, 2026). One in Five Ethiopian Women Abandon Contraception Within a Year, Survey Finds. Scienmag.
