Title: Implants
Course: Adolescent and Youth Reproductive Health - Ethiopia (Full)

Implants

What types of implants do you know that could be used by a young woman. How long does each of them prevent pregnancy?

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As you learned in the Family Planning Module, there are two types of implants that are being widely used in Ethiopia. These are: (1) Implanon: one rod, effective for three years, (2) Jadelle: two rods, effective for five years.

Figure 8.6 An implant.

Implants (Figure 8.6) are safe and appropriate for young girls and can be safely used by those who are infected with HIV or have AIDS, or are on antiretroviral (ARV) therapy. However you should urge these women to use condoms with implants.

These girls are already infected, so why should they use condoms?

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They should use condoms to prevent the spread of infection to their partner and also protect themselves from infection by a new strain of HIV, which the doctors call cross-infection.

You see some of the reasons why young people like implants in Box 8.1 below.

Box 8.1 Why some young girls say they like implants

- Implants do not require the user to do anything once they are inserted.
- Implants prevent pregnancy very effectively.
- They are long-lasting.
- They do not interfere with sex.

Why do you think young people discontinue using implants?

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The main reason for the discontinuation of implants is menstrual problems, especially irregular bleeding.

You have learned how you can respond to misconceptions and rumours in the Family Planning Module. Do you remember what misunderstandings on implants exist?

Young people think that implants move to other parts of the body, stop menstrual bleeding, lead to pregnancy outside the uterus (ectopic pregnancy), and make the woman unable to become pregnant even if removed (Figure 8.7).

Figure 8.7 Women discussing using contraceptive implants.

Young girls often have misunderstandings concerning implants. You need to identify what specific misunderstandings they have during your discussion with them on contraceptives and correct them.

Remember it is important to provide information about side-effects, to correct misunderstandings and to give counselling before providing contraception (Figure 8.8).

Figure 8.8 A Health Extension Practitioner explaining different methods of contraception and giving counselling on their advantages and side-effects.

Why must you give information about side-effects and provide counselling before giving contraception.

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The woman may not return to seek your help/advice once she has the implant.

In Box 8.2 below, you see some of the points you can use to correct young people's misunderstandings about implants.

Box 8.2 Correcting common misunderstandings about implants.

- Implants do not make women infertile.
- Implants stop working once they are removed, and the woman can become pregnant again; after removal of the implant, fertility returns within 4–6 months — or sooner.
- Implants can stop monthly bleeding, but this is not harmful.
- Implants do not move to other parts of the body.
- Implants substantially reduce the risk of ectopic pregnancy.

Counselling is essential because young girls must be prepared for irregular bleeding and must make plans about how they and their partner will react to the irregular bleeding. You should counsel them very thoroughly on the potential side effects of implants, mainly the irregular bleeding.

From your own experience say which type of girls are most likely to choose and use implants?

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Girls who select implants are most likely to want three to five years of contraceptive protection, have often experienced failure of other methods, can tolerate a small surgical procedure, and have access to services.

If a young girl chooses to use implants, you should make sure that she will have access to services to remove the implant whenever necessary.

Remember, you should also encourage girls who choose to use implants to use condoms as well because implants do not protect against STIs/HIV.