Reasons for Drop-Out Among Contraceptive Pill and Injectable Acceptors at a Comprehensive Family Planning Center of a Tertiary Government Hospital in the Philippines From April 1-30, 2025: A Qualitative Cross-Sectional Study

Abstract Introduction. Family planning is a critical catalyst for achieving Sustainable Development Goal (SDG) Target 3.7, promoting gender equality, and empowering women to participate in education and the workforce. In the Philippines, while the modern contraceptive prevalence rate (mCPR) has risen to 58%, an “unmet need” of 12% persists, largely due to high drop-out rates among women who previously used a method but discontinued it. Understanding the drivers behind this discontinuation is essential to bridging the gap between contraceptive intent and long-term use. Objectives. This study aims to determine the reasons for contraceptive drop-out among contraceptive pill and injectable acceptors at the Advanced Comprehensive Family Planning Services, Research and Training Center (CFPC) of Dr. Jose Fabella Memorial Hospital. It seeks to analyze socio-demographic profiles and identify themes leading to missed follow-ups to improve counseling, operational efficacy, and standard of reproductive care. Methods. The study utilized a qualitative cross-sectional study using a narrative inquiry approach was employed. The study targeted women registered as “acceptors” of short-term hormonal methods, such as contraceptive pills and injectables, who missed scheduled follow-ups in April 2025. Purposive sampling was used to obtain a sample of 45 participants (reaching thematic saturation) from a pool of 248 identified drop-outs. Data was collected via telephone interviews by trained facilitators and analyzed using frequency distributions for demographics and Inductive Thematic Modeling for narrative data. Results. The participant profile primarily consisted of housewives, with secondary education, Roman Catholics, women aged 30–39, living in with partner and residing within the National Capital Region. Four major themes for drop-out emerged: Health System and Personal Access Issues: The most prominent theme, with subthemes of location, time, and financial constraints. Medical Problems: Specifically adverse side effects like irregular bleeding or weight gain. Socio-cultural and Family Barriers: with subthemes of lack of partner support, having a partner working abroad (OFW), or a desire for another pregnancy. Lastly, Lack of Awareness: Resulting in missed intake or confusion regarding scheduled follow-up dates. Discussion. The dominance of access issues suggests that for working-class housewives, “financial constraints” are often tied to logistical hurdles like travel costs (“walang pamasahe”) rather than the cost of the contraceptive itself. Medical side effects remain a critical barrier, even for the majority of participants who explicitly wished to avoid future pregnancies, highlighting a need for better initial counseling to manage expectations. The complexity of short-term regimens also poses a challenge for younger acceptors or those with limited health literacy. Conclusion. Contraceptive discontinuation is a multifaceted process driven by an intersection of systemic gaps, physical burdens, and domestic circumstances. To improve continuation of family planning method, healthcare interventions must evolve beyond the provision of supplies to include integrated support strategies. Key recommendations include proactive side-effect management, decentralized care through partnerships with local health units, enhanced male engagement to foster domestic support and empowerment programs. Addressing these barriers is vital for ensuring family planning effectively promotes social equity in the Philippine health system.