Beksinska ME, Rees VH, Nkonyane T and McIntyre JA

Compliance and use behaviour, an issue in injectable as well as oral contraceptive use? A study of injectable and oral contraceptive use in Johannesburg.

Br J Fam Plann. 1998 Apr;24(1):21-3.


This study examines the compliance, use behaviour and knowledge of method of women using injectable and oral contraceptives in two clinic sites in the Johannesburg area, South Africa. An interviewer administered questionnaire was used to collect information in the clients' home language. A total of 400 women were interviewed in the clinics. The mean age of clients was 26.2 years (range 13 to 43 years). Of the clients not wanting to get pregnant, 30.4 per cent of injectable users and 18.4 per cent of oral contraceptive (OC) users had stopped using their method temporarily before returning to the same method (called the nonuse segment) and had not used any other form of contraception during this time. Almost one third of injectable users (31.2 per cent) had been late for their next injection at least once. Although nearly all women using injectables had experienced some menstrual disturbances, over one third (38.5 per cent) had not been informed by the providers about the possibility of these changes. Many women gave the disruption of their menstrual cycle as the reason for the nonuse segment. The majority of OC users lacked information on how to use their method correctly. Nearly all women expressed an interest in obtaining more information on their current method and other available methods. This study shows that compliance is an issue in injectable as well as OC users.

Comment: Although the general belief is that injectable contraception increases the compliance, this report shows that – like with oral pills – compliance can be challenge with injections.
This may also be a place to emphasize again the need to explain to women what to do after a pill has been forgotten: forgetting one or two pills in the middle of the "pill-cycle" is usually no problem, while forgetting the first or the last pill of a strip lengthens the pill-free interval, and that can lead to pregnancy. (HMV)