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Introduction: Discontinuation of the intrauterine contraceptive device (IUCD) is defined as the removal of the method within 12 months of initiation. Early discontinuation represents a critical public health issue, as it elevates the risk of unintended pregnancies, which may subsequently result in unsafe abortions and unplanned births. Despite ongoing efforts by the Ethiopian government to expand access to and utilization of long-acting reversible contraceptives (LARCs), particularly IUCDs, uptake remains suboptimal among women of reproductive age. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of IUCD discontinuation in Ethiopia. Methods: This systematic review and meta-analysis was prospectively registered in the PROSPERO database (registration number: CRD420251107378). A comprehensive literature search was conducted across major electronic databases, including PubMed, Google Scholar, Cochrane Library, and Embase. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analyzed using STATA version 14 (StataCorp, College Station, TX, USA). A random-effects model was employed to estimate the pooled prevalence of intrauterine contraceptive device (IUCD) discontinuation. Statistical heterogeneity among studies was assessed using the I 2 statistic, while publication bias was evaluated using Egger’s regression test. Results: A total of four studies comprising 1,874 participants were included in this systematic review and meta-analysis. The pooled prevalence of intrauterine contraceptive device (IUCD) discontinuation in Ethiopia was 29.54% (95% CI: 12.68–46.40). Subgroup analysis by region revealed considerable variation, with the highest discontinuation rate observed in Addis Ababa at 60.67% (95% CI: 55.81–65.52), followed by the Oromia region at 20.56% (95% CI: 16.57–24.55), and the Southern Nations, Nationalities, and Peoples’ Region (SNNPR) at 18.67% (95% CI: 16.36–20.98). Conclusion: The evidence indicates a relatively high pooled rate of intrauterine contraceptive device (IUCD) discontinuation in Ethiopia. This finding underscores the need for targeted interventions to reduce early discontinuation and enhance the acceptability and sustained use of IUCDs among women of reproductive age in Ethiopia.
Chuko et al. (Wed,) studied this question.