Evidence map›Paper›PMID 40102954›Full record

ArticleContraception and reproductive medicine2025

"I felt my rights were violated": Challenges with the discontinuation of provider-dependent contraceptive methods in Eastern Uganda.

Agnes Nabulondera, Madeline Powers, Rose Chalo Nabirye, Sarah Racheal Akello, Munanura Turyasiima, Joshua Epuitai

Abstract read
In one paragraph

Article in Contraception and reproductive medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Agnes NabulonderaDepartment of Nursing, Faculty of Health Sciences, Busitema University, P.O Box 1460, Mbale, Uganda.
Madeline PowersDepartment of Nursing, Faculty of Health Sciences, Busitema University, P.O Box 1460, Mbale, Uganda.
Rose Chalo NabiryeDepartment of Nursing, Faculty of Health Sciences, Busitema University, P.O Box 1460, Mbale, Uganda.
Sarah Racheal AkelloDepartment of Nursing and Midwifery, Muni University, P.O Box 725, Arua, Uganda.
Munanura TuryasiimaDepartment of Standards Compliance Accreditation and Patient Protection, Ministry of Health, P.O Box 7272, Kampala, Uganda.
Joshua EpuitaiDepartment of Nursing, Faculty of Health Sciences, Busitema University, P.O Box 1460, Mbale, Uganda. joshuaepuitai@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe right to autonomy in family planning is a cornerstone of reproductive health. Yet, many women face challenges when seeking to discontinue provider-dependent contraceptive methods, such as implants and intrauterine devices (IUDs). This study explored the experiences of women in Eastern Uganda regarding the discontinuation of implants/IUDs.

methodsUsing a qualitative descriptive design, we conducted 15 in-depth interviews with women and six key informant interviews with healthcare providers. The study obtained ethical clearance and used a thematic analysis.

resultsTwo themes were identified: (1) reasons for refusal and (2) women's reactions to refusal to discontinue IUDs/implants. Women were denied to discontinue IUDs/implants because the due date had not been reached, insertion cards were missing, and there were healthcare constraints, especially inadequate equipment. Early removal or discontinuation before the due date was considered as a waste of resources, unjustifiable, and it was seen to increase risk of pregnancy among young girls. Healthcare workers preferred to first counsel for side effects instead of heeding women's requests to discontinue IUDs/implants. Women often felt betrayed and powerless when they were denied to discontinue using IUDs/implants. They felt that their reproductive rights were undermined which fostered mistrust towards future use of provider-dependent contraceptives. Women reported physical, social, and mental health struggles including strained marital relationships following denial to discontinue IUDs/implants. Most of the women incurred costs in discontinuing the use of IUDs/implants in private facilities.

conclusionThe findings underscore the need to uphold women's autonomy by improving access to removal services, and addressing systemic and provider-level barriers to discontinuation of IUDs/implants. Insertion cards should not be a mandatory requirement during discontinuation of contraceptives, while enhancing record-keeping systems can address the need for insertion cards. Respecting women's rights to discontinue contraceptives is essential for ensuring voluntary and sustained family planning use.

Indexed as

Contraceptive discontinuationHuman rights in family planningProvider-dependent methodsReproductive autonomy

Identifiers

PMID40102954
PMCPMC11917070

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.