Contraceptive continuation among women aged 15-49 utilizing City of Cape Town family planning services
Bibliographic record
Abstract
There is a need to provide comprehensive contraceptive services that are consistent and that address the requirements of women, particularly young women who are at risk of unintended pregnancy. Objectives This study describes characteristics of contraceptive users accessing services and their contraceptive method usage patterns, including continuation, at public sector clinics in Cape Town, South Africa. Methods The study reviewed data on contraceptive users (n=217 274), aged 15-49 years accessing services across 102 public sector clinics. We calculated all method continuation and method-specific continuation for all hormonal methods. Multi-variate analysis was used to examine the relationship between sociodemographic and health characteristics with contraceptive continuation. P-values <0.05 were considered significant. Results Of the 217 274 women, 95.6% used short acting methods (68.2% injectables, 9.1% oral pills, 18.2% male & female condoms), while <5% used long-acting methods (implant 3.9%, intrauterine device 0.4%). The proportion of all method continuation was 39.5%, but the norethisterone enanthate injectable had the lowest method-specific continuation at 8%, followed by the oral pill at 11%, the two most popular contraceptive methods used by younger women. Contraceptive continuation was strongly associated with dual method use (OR: 1.78; 95% CI: 1.74-1.84), older age (25-49) (OR: 1.16; 95% CI:1.13-1.18) and had reduced odds if a user was on treatment for TB (OR: 0.64; 0.57-0.73). Conclusions Both method-specific and all-method contraceptive continuation were low, which indicates high rates of contraceptive method discontinuation without women switching their method. This may point to issues requiring attention at health provider, health system and client levels. Expanding patient- centered counselling and education, ongoing in-service education of health providers, and inventory monitoring systems to address issues such as stockouts are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".