This paper investigates the importance of women's physiological condition, alongside sociocultural factors, for predicting the risk of discontinuation of the injectable contraceptive due to side effects in Ethiopia. Contraceptive calendar data from the 2016 Ethiopian Demographic and Health Survey were analyzed. Women aged 15–49 who had initiated the injectable contraceptive in the last two years were included in the analysis (n = 1,513). Physiological factors investigated were body mass, iron status, reproductive depletion, and physical strain. After checking for reverse causality, associations between physiological and sociocultural risk factors and discontinuation due to side effects (DSE) or discontinuation due to other reasons (DOR) were estimated using multivariate Cox proportional regression analyses. Anemia status was associated with DSE, but not DOR. Anemic women were two times more at risk of DSE compared with nonanemic women (adjusted hazard ratios [aHR] = 2.38, confidence interval [CI] = 1.41–4.00). DOR was predicted by religion, wealth, and relationship status. Accounting for diversity in physiological condition is key for understanding contraceptive discontinuation due to side effects. To reduce side effects, family planning programs might benefit from providing hormonal contraception within an integrated package addressing anemia.

中文翻译：

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埃塞俄比亚贫血妇女因副作用而更容易停用注射避孕药

本文调查了女性生理状况以及社会文化因素对预测埃塞俄比亚因副作用而停用注射避孕药的风险的重要性。分析了 2016 年埃塞俄比亚人口与健康调查的避孕日历数据。分析中包括在过去两年中开始使用注射避孕药的 15-49 岁女性（n = 1,513）。研究的生理因素是体重、铁状态、生殖耗竭和身体劳损。在检查反向因果关系后，使用多变量 Cox 比例回归分析估计生理和社会文化风险因素与因副作用 (DSE) 或因其他原因导致的停药 (DOR) 之间的关联。贫血状态与 DSE 相关，但与 DOR 无关。与非贫血女性相比，贫血女性患 DSE 的风险高出两倍（调整后的风险比 [aHR] = 2.38，置信区间 [CI] = 1.41–4.00）。DOR 是由宗教、财富和关系状况预测的。考虑生理条件的多样性是理解因副作用而停止避孕的关键。为了减少副作用，计划生育计划可能会受益于在解决贫血症的综合方案中提供激素避孕。考虑生理条件的多样性是理解因副作用而停止避孕的关键。为了减少副作用，计划生育计划可能会受益于在解决贫血症的综合方案中提供激素避孕。考虑生理条件的多样性是理解因副作用而停止避孕的关键。为了减少副作用，计划生育计划可能会受益于在解决贫血症的综合方案中提供激素避孕。