Uptake and early removals of Implanon NXT in South Africa: Perceptions and attitudes of healthcare workers

O Adeagbo; S Mullick; D Pillay; M Chersich; C Morroni; N Naidoo; M Pleaner; H Rees

doi:10.7196/SAMJ.2017.v107i10.12821

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Uptake and early removals of Implanon NXT in South Africa: Perceptions and attitudes of healthcare workers

Journal article

Open access

Peer reviewed

Uptake and early removals of Implanon NXT in South Africa: Perceptions and attitudes of healthcare workers

O Adeagbo, S Mullick, D Pillay, M Chersich, C Morroni, N Naidoo, M Pleaner and H Rees

South African medical journal, Vol.107(10), pp.822-826

10/01/2017

DOI: 10.7196/SAMJ.2017.v107i10.12821

PMID: 29397681

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https://doi.org/10.7196/SAMJ.2017.v107i10.12821View

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Abstract

Background. The South African (SA) government introduced Implanon NXT, a long-acting subdermal contraceptive implant, in 2014 to expand contraceptive choice. Following an initial high uptake, its use declined considerably amid reports of early removals and frequent side-effects. We examine providers’ perceptions of training and attitudes towards Implanon NXT, as well as their views on the causes of early removals and the impact on the implant service. Objective. To assess healthcare providers’ perceptions and attitudes towards implant services in SA. Methods. In-depth interviews were conducted with eight nurses providing implant services in public facilities in Gauteng and North West Province. Emerging themes were identified, manually coded and thematically analysed following an interpretivism approach. Results. Nurses lacked confidence in providing implant services effectively, particularly removals, which they ascribed to the brief, cascade-type training received. Nurses generally held negative views towards the method. They also reported that side-effects are the most common reason for early removals – particularly irregular bleeding – and that men often do not support their partners who use the method. Lastly, it was found that providers require guidance on counselling regarding the method and standardised guidelines on the management of side-effects. Conclusion. Retraining and support of providers are needed to address competency gaps and negative attitudes towards the method. Assessment of providers’ readiness to perform removal procedures is also important. Finally, effective plans are necessary to improve implant continuation rates, especially among women whose partners are unsupportive.

Adult

Amenorrhea - chemically induced

Attitude of Health Personnel

Contraception - adverse effects

Contraception - statistics & numerical data

Device Removal - statistics & numerical data

Female

Health Personnel - psychology

Humans

Intrauterine Devices - adverse effects

Intrauterine Devices - statistics & numerical data

Male

South Africa

Young Adult

Details

Title: Subtitle: Uptake and early removals of Implanon NXT in South Africa: Perceptions and attitudes of healthcare workers
Creators: O Adeagbo - University of the Witwatersrand
S Mullick - University of the Witwatersrand
D Pillay - University of the Witwatersrand
M Chersich - University of the Witwatersrand
C Morroni - University of Cape Town
N Naidoo - University of the Witwatersrand
M Pleaner - University of the Witwatersrand
H Rees - University of the Witwatersrand
Resource Type: Journal article
Publication Details: South African medical journal, Vol.107(10), pp.822-826
DOI: 10.7196/SAMJ.2017.v107i10.12821
PMID: 29397681
NLM abbreviation: S Afr Med J
ISSN: 0256-9574
eISSN: 2078-5135
Language: English
Date published: 10/01/2017
Academic Unit: Community and Behavioral Health
Record Identifier: 9984274821002771

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