Contraceptive Discontinuation Rates among Displaced Populations in Internally Displaced Persons’ (IDP) Camps of Borno State, Nigeria

Abstract

Background: Contraceptive discontinuation remains a critical challenge in humanitarian settings, yet limited evidence exists on displaced populations in Nigeria. This study examined contraceptive discontinuation rates and associated patterns among women in Internally Displaced Persons’ (IDP) camps in Borno State.

Methods: A cross-sectional study was conducted among 1,200 women of reproductive age residing in IDP camps. Data on contraceptive use, method type, duration of displacement, and reasons for discontinuation were collected and analysed using incidence rates, incidence rate ratios (IRRs), and method-specific continuation patterns.

Results: Overall discontinuation was higher among recently displaced women (<24 months: 270 discontinued vs. 330 continued) compared with longer-term displaced (≥24 months: 168 discontinued vs. 432 continued). The incidence rate of discontinuation was 50.0 per 100 person-years among recent displacements versus 28.6 per 100 person-years for longer-term displacements (IRR = 1.75; 95% CI: 1.44–2.12). Method-specific analysis showed that short-term methods such as condoms (90.0 per 100 PY) and pills (72.0 per 100 PY) had the highest discontinuation rates, while implants (28.0 per 100 PY) and injectables (56.0 per 100 PY) demonstrated greater continuation. Reported reasons for discontinuation varied by displacement duration, with side effects and health concerns most common (38–42%), followed by stock-outs (24% vs. 16%) and fertility desire (18% vs. 26%).

Conclusion: Contraceptive discontinuation in IDP camps is strongly associated with displacement duration, method type, and socio-cultural as well as health-system factors. Early introduction and coordinated implementation of the Minimum Initial Service Package (MISP) for Sexual and Reproductive Health in crisis situations is recommended for strengthening supply chains, expanding access to contraceptive methods, addressing other gaps to enhance contraceptive continuation and reproductive autonomy among displaced women in Borno State, Nigeria.