ABSTRACT
A non-comparative study of the Norplant contraceptive subdermal implant system was conducted in Kumasi, Ghana. A total of 100 acceptors were enrolled in the clinical trial, which began in 1987. There were no pregnancies during the first two years of use. Only nine post-insertion medical problems were reported during the first two years of use. One woman in this study requested removal for menstrual pattern changes through two years of use. As assessed through user-satisfaction questionnaires administered at approximately six months of use, there has been an overall positive user experience with Norplant in this study. Although the sample size in this study is small, our results seem to be consistent with other studies and it appears that Norplant offers an effective, safe and acceptable method of contraception for Ghanaian women.
PIP: A two-year pre-introductory study of 100 Norplant acceptors from Kumasi, Ghana, indicated that the contraceptive implants are safe, effective, and acceptable to this population. The mean age of study participants was 31.2 years; they had completed an average of 8.3 years of schooling and had a mean of 4.4 live births. Although 35% did not want any more children, 64% had used no contraceptive method in the month prior to study admission. No pregnancies were reported during interviews at 1, 3, 6, 12, 18, and 24 months post-insertion. The continuation rate was 86.6/100 women at two years, for a total of 2119 woman-months of use. 75 women elected to continue Norplant use, while 12 opted for removal and 13 were lost to follow-up. Reasons for discontinuation included desire for pregnancy (3), husband's insistence (5), travel (2), menstrual problems (1), and tuberculosis (1). Only nine acceptors reported any adverse effects; most frequent were itchiness and infection at the implant site. The incidence of amenorrhea decreased from 27% at the end of the first year of use to 2% by the end of the second year. When asked to identify the most attractive feature of the Norplant system, half the respondents cited its five-year duration of action; most disliked was Norplant's effect on the menstrual cycle. 83.7% indicated they would recommend Norplant to a friend, and 55% expressed an interest in having a second set of implants inserted after the full five years.
