Research Article
Volume 10 Issue 5 - 2021
Factors Associated with Loss to Follow-up among Acceptors of Modern Contraceptive Methods at the Family Planning Clinic of a Tertiary Hospital in Port-Harcourt, Nigeria
Peter A Awoyesuku*, Ngozi J Kwosah, Basil O Altraide and Chinweowa Ohaka
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Old G.R.A, Port-Harcourt, Nigeria
*Corresponding Author: Peter A Awoyesuku, Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Old G.R.A, Port-Harcourt, Nigeria.
Received: February 15, 2021; Published: April 16, 2021


Background: Routine follow-up is recommended for safe and effective use of contraception in healthy women. However, it has been observed, that a large proportion of acceptors never return to the clinic for follow-up.

Objective: To investigate this problem, this study sought to determine the rate and factors associated with Lost to follow-up (LFU) among acceptors of modern contraceptives at a family planning clinic in a tertiary hospital.

Methodology: This was a retrospective descriptive study of All women who initiated a modern contraceptive method between 1st January 2014 and 31st December 2018, that were lost to follow-up. Data were retrieved from the hospital records and case notes of all the women using a proforma data sheet. Information on maternal age, parity, educational status, contraceptive use intention (spacing or limiting) and method chosen were retrieved. Data were entered into Excel sheet and analyzed with SPSS version 20. Chi-square test and Fisher’s exact test for categorical variables were used for bivariate analysis and multiple logistic regression was applied to test for significant association with P-values of < 0.05 taken as significant.

Results: There were 168 LFU acceptors (of 517 total acceptors) during the five-year study period giving a LFU rate of 32.5%. The Mean age of the LFU acceptors ± SD was 34.36 ± 5.28 years and median parity was Para 3. Majority 103 (61.3%) accepted Implants followed by the IUDs in 64 (38.1%). Majority 105 (62.5%) initiated contraception for completed family size. Significantly more LFU acceptors were using contraception for completed family size than for child spacing compared to those who continued follow-up. There was significant association between LFU acceptors with age (P = 0.001) and education (P = 0.047), but not with parity (P = 0.259). However, following logistic regression analysis, only age remained statistically significant (P = 0.002). Women > 30 years of age were almost twice as likely to be LFU than those below ≤ 30 years.

Conclusion: The LFU rate of 32.5% in this study is unacceptably high. Older women over 30 years using contraception for completed family size were more likely to be lost to follow-up. There is need to identify means of reducing LFU. Recording contact details such as e-mail and cell phone numbers can assist in follow-up with women who do not keep appointments. Improved participant retention will improve validity of programs and allows for important clinical outcomes, such as pregnancy, to be assessed.


Keywords: Modern Contraceptives; Loss to Follow-up; Associated Factors; Family Planning; Port-Harcourt


  1. Awoyesuku PA and Altraide BOA. “Contraceptive Choices and Acceptability among New Clients Attending Family Planning Unit of Rivers State University Teaching Hospital, Nigeria”. Journal of Advances in Medicine and Medical Research3 (2019): 1-7.
  2. Trussel J. “Methodological pitfalls in the analysis of contraceptive failure”. Statistics in Medicine 2 (1991): 201-220.
  3. Tietze C and Lewis S. “Recommended procedures for the statistical evaluation of intrauterine contraception”. Studies in Family Planning 2 (1973): 35-42.
  4. Tietze C., et al. “The clinical effectiveness of the rhythm method of contraception”. Fertility and Sterility 5 (1951): 444-450.
  5. Faundes A. “Factors Associated with Loss to Follow-up Among Acceptors of the Levonorgestrel-releasing Intrauterine System at a Public-sector Family Planning Clinic in Brazil”. Jacobs Journal of Gynecology and Obstetrics (2018).
  6. Dubrow H and Kuder K. “Combined Postpartum and Family Planning Clinic”. Obstetrics and Gynecolog 11 (1958): 586.
  7. Creedy BS and Polgar S. “Returning for Yearly Check-ups: A study of 22,000 Family Planning Clients”. New York: Planned Parenthood-World Population, mimeo 1063.
  8. Nygren KG., et al. “Intrauterine contraception with Nova-T and Copper-T-200 during three years”. Contraception5 (1981): 529-542.
  9. Escudero F., et al. “Factors associated with discontinuation rates of the Copper T380A in a Peruvian public hospital”. Advances in Contraception 4 (1999): 303-311.
  10. Phillips SJ., et al. “Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study”. American Journal of Obstetrics and Gynecology 1 (2017): 57.e1-57.e6.
  11. Bracken MB and Kasi SV. “Factors Associated with Dropping out of Family Planning Clinics in Jamaica”. American Journal of Public Health 3 (1973): 262-271.
  12. Torres LN., et al. “We should really keep in touch: predictors of the ability to maintain contact with contraception clinical trial participants over 12 months”. Contraception6 (2014): 575-580.
  13. Rivera R., et al. “Analysis of client characteristics that may affect early discontinuation of the TCu-380A IUD”. Contraception3 (1999): 155-160.
Citation: Peter A Awoyesuku., et al. “Increasing Trends of Caesarean Deliveries in India: Does the Private Sector Contribute to it?”.Dhananjay W Bansod., et al. “Increasing Trends of Caesarean Deliveries in India: Does the Private Sector Contribute to it?”. EC Gynaecology 10.5 (2020): 63-70.

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