ABSTRACT

Objective: The prevalence of sub-dermal contraceptive implant use in Jamaica is low despite growing international acceptance of long-acting reversible contraception (LARC). We assessed the availability, effectiveness, side-effects and utilization of sub-dermal contraceptive implants, and described characteristics of users over a one-year period.

Methods: We reviewed medical records of women aged 15-45 years who had contraceptive implant-related services at any of six public health centers in Jamaica during 2013, and surveyed twenty available healthcare providers.

Results: In 2013, 738 women attended a Jamaican public health center for contraceptive implant service; 493 (67%) for insertion, 202 (27%) for removal, and 53 (7%) for follow-up visits. The women’s median age was 26.0 years and 24% were ≤18 years; 85% had > 1 child. Most women (69%) did not have documented side effects; irregular bleeding, the most commonly documented side effect, was recorded for 24%. Of the 493 women who had implants inserted, three (0.6%) were determined to be pregnant within three months of insertion. Among the 202 women who had implants removed, 11 (5.4%) experienced complications with removal. Providers highlighted the need for expansion of contraceptive implant availability and provider training.

Conclusion: Sub-dermal implants have few insertion complications and side-effects, and are effective, but underutilized in Jamaica. Increased implant availability and enhanced provider training may improve implant utilization and reduce unintended pregnancy rates in Jamaica