Seasonal Contraceptive Discontinuation Patterns: An analysis using the Demographic and Health Survey (DHS) contraceptive calendar in 6 countries

Unmet need for family planning puts women at risk for unintended pregnancies; however, unmet need is made up of both women who have never used a method of family planning and those who have used a modern method but subsequently discontinued. Understanding patterns of discontinuation can inform policies and practices to reduce unmet need for family planning and therefore promote gender equity and maternal and infant health. In this paper, we explore seasonal contraceptive patterns in Kenya, Uganda, Indonesia, Afghanistan, Ethiopia, and Nepal using the Demographic and Health Survey (DHS) contraceptive calendar from the most recent survey in each country prior to Covid-19. Specifically, we investigate contraceptive discontinuation associated with major holidays – times when women may travel or health facilities may close. Even after accounting for recall bias, major holidays appear to drive contraceptive discontinuation in a subset of countries and could serve as a powerful point for intervention.