The use of depot medroxyprogesterone acetate (DMPA) injectable contraceptive in Enugu, Nigeria.

Contraception with Depot Medroxyprogesterone Acetate (Depo provera) is quite effective though not without side effects that may cause discontinuation amongst acceptors. To evaluate client characteristics, their experiences and acceptability of Depo provera in Enugu and compare these with previous experiences elsewhere. A review of the family planning records of new acceptors who used Depo provera between 1st January 2000 and 31st December 2005 at the family planning clinic of University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. Within the study period, 684 new clients accepted Depo provera, accounting for 21.4% of all new acceptors for various forms of contraception. The mean [+/- SD] age and parity of the 590 acceptors whose records were available were 34.40 +/- 6.03 years and 5.52 +/- 2.02 respectively. Seventy percent (70%) of the clients had 5 or more children. Most (51.6%) had primary education. Seventy percent of clients with 5 or more children wanted no more children while 30% of those gainfully employed use of Depo provera for child spacing. Fifty seven percent of clients accepted Depo provera within a year following confinement and 80.2% of them were breast feeding. Complications occurred in 54.2% of all acceptors, with menstrual abnormalities occurring in 94.4% of them. Secondary amenorrhoea was the commonest menstrual anomaly occurring in 81.1% of clients with menstrual problems. Discontinuation in use Depo provera was 51.5% after the first one year. Irregular injection schedules and default were common with a continuation rate of 25.6% at the end of they observation period. However, the complaints of side effects appeared to wane beyond the second year of use. Three accidental pregnancies (0.5%) occurred during the study period. Depot medroxyprogesterone acetate injectable contraceptive is an effective method of contraception in Enugu. It is accepted mainly by clients that have completed their family and are breast feeding. Awareness of its side effects obviously enhances continuation.