SynthesisReproductive health2025
Quality matters: the role of service quality in discontinuation of long-acting reversible contraceptives in Sub-Saharan Africa; systematic review and meta-analysis.
Synthesis in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- Determinants and predictive modeling of long-acting reversible contraceptive use in Sub-Saharan Africa: evidence from DHS data using machine learning and association rule mining.AJOG global reports · 2026Article
- Family planning service quality and contraceptive discontinuation among short-acting contraceptive users in Indonesia: a survival analysis of the 2017 Indonesia demographic health survey.BMC women's health · 2026Article
- Multilevel analysis of factors associated with abortion among adolescents in Uganda insights from UDHS 2022 dataset.PLOS global public health · 2026Article
- Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong-acting reversible contraceptives (LARC) are safe, reliable, and convenient for women in low and lower-middle-income countries with limited access to healthcare. Despite the progress in the uptake of LARCs, early discontinuation remains a significant issue. Discontinuation is an important indicator of the quality and effectiveness of family planning services; however, no reviews investigate this relationship in Africa. This systematic review and meta-analysis aimed to assess the effect of the quality of family planning services on LARC discontinuation in Sub-Saharan Africa.
methodsWe conducted a comprehensive search using electronic databases, including EMBASE, Medline, Web of Sciences, Scopus, CINAHL, and ProQuest, which was supplemented by manually searching relevant articles. The Newcastle- Ottawa Scale (NOS) assessment tool was used for quality appraisal. The I
resultTwenty articles with 9,774 reproductive-aged women were included in this systematic review and meta-analysis. Women who did not receive family planning counselling services had 2.59 times the odds of discontinuing LARC use than those who received counselling services (POR = 2.59; 95% CI = 1.81 to 3.72). Moreover, women dissatisfied with their family planning services had 4.67 times the odds of discontinuing LARC use than those who were satisfied (POR = 4.67; 95% CI: 3.11 to 7.01).
conclusionEnhancing the quality of family planning counselling and addressing client dissatisfaction are essential strategies for reducing LARC discontinuation in Sub-Saharan Africa. Policymakers and healthcare providers should prioritise improvements in service quality by strengthening counselling services and promoting a more client-centred approach to enhance client satisfaction. Given the persistent issue of FP discontinuation in the region, these findings underscore that further research using robust, quality measures and a longitudinal or interventional design is needed to understand causal relationships and guide service improvements.
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