Dr. Jim Shelton's Pearls: Contraceptive Implants for Young Women

Jim Shelton

CCP | Editor-in-Chief, Global Health Science & Practice

Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

Question:  Contraceptive implants are becoming very popular in our program here [at USAID], but we are especially concerned about unintended pregnancy among young women. Do you think they are suitable and popular for young women?

Answer:  Definitely. For example, a recent study from Kenya offered implants to women 18-24 who specifically came to the clinic seeking an injectable or oral contraceptives. About a quarter (97 of 396) of those young women eligible, chose implants. The results were remarkable:

  • At 18 months, continuation was 79%, versus 57% for those selecting oral contraceptives or injectables.
  • There were no unintended pregancies reported among those choosing implants, versus an 8.5% unintended pregnancy rate at 18 months for those selecting oral contraceptives or injectables.

These results are notable because they reflect a pretty realistic situation:

  • It took place in pretty typical Nairobi clinic.
  • It did not reflect the very intensive intervention often seen in clinical trials and there was no special intensive follow-up schedule.

The young women in the two groups were similar in that they all had to have come to the clinic intending to use either oral contraceptives or the injectable. And the investigators controlled for factors such as education in the analysis. Still, those selecting implants may have been more motivated in some way. Nevertheless, the high proportion choosing implants, the excellent continuation, and the lack of unintended pregnancy are remarkable.

Review the study manuscript.