A pilot study to compare discontinuation, side-effects, cost-effectiveness and implementation challenges between 3rd and 2nd generation Oral Contraceptive Pill (OCP) in one upazilla in Bangladesh

This study aimed i) to compare the discontinuation rate along with the reasons for discontinuation of 3rd and 2nd generation OCPs ii) to document the side-effect profile and satisfaction levels for the above two types of OCPs iii) to compare the level of compliances (correct and regular use) of each of the OCP type iv) to investigate the advantages and challenges related to the distribution of 2nd and 3rd generation OCPs among the clients v) to document the opinion of the policy makers and program personnel about the importance of introducing the 3rd generation OCP in the national program vi) to assess the cost effectiveness of 3rd generation OCP than the 2nd generation OCP. A community trial was conducted in 2 unions (one intervention and one control) of the Sarankhola upazila of Bagerhat district where OCP discontinuation rate was high (30%). The study employed both quantitative and qualitative research methods to address the objectives. Cost analysis was done for assessing the cost-effectiveness of the intervention. In each intervention and control area, 1400 eligible women were recruited after screening, checking for the selection criteria performed by the existing family planning field workers (FWAs/FWVs). Women in the intervention group were provided with 3G-OCP and those in the control group had 2G-OCP; 2 cycles at enrolment and 2 cycles at each of the 2 follow-up visits at home by the FWAs/FWVs. All the women in both the groups were interviewed three times: at enrollment and at two subsequent follow-up visits at home at 3-months apart by the study interviewers for collecting detailed information on their OCP use related practices, side-effects, continuation status including the reasons for discontinuation when applicable. In addition, under the qualitative component, the study conducted 6 Focus Group Discussions (FGDs) with the clients who continued and those who discontinued the OCPs in this study for their perceived satisfaction and dissatisfaction with the type of OCPs they had used. A series of in-depth interviews of the family planning field workers and their supervisors; service providers; program managers and community leaders were also conducted for their perception on advantages and challenges related to distribution of 2nd and 3rd generation OCPs to the clients. The team also documented their opinion about the need of introducing the 3rd generation OCP in the national program.