Background: The current contraceptive uptake in Ethiopia is low and dominated by short-acting methods. Discontinuation rate is also high. This analysis was done to identify reasons and factors associated with long-acting and reversible contraceptives (LARC) discontinuation.

Methods: A total of 1385 LARC episodes were included in the analysis. The event file generated from the contraceptive calendar was merged to the original data set to identify predictors of LARC discontinuation.

Result: About 45% IUD and 61% of implant episodes were discontinued at the end of 36 months. Side effects and the desire to become pregnant were the main reasons for discontinuation. Older women (age 25 – 34 and 35 - 49) (HR=0.26; 95%C: 0.20 – 0.35 and HR=0.17; 95%C: 0.11 – 0.26, respectively), women partially or fully participated in decisions making (HR=0.53; 95%C: 0.37 – 0.78 and HR=0.55; 95%C: 0.40 – 0.74 respectively) and primipara women had a lower probability (HR=0.53, 95%CI: 0.33 – 0.86) to discontinue LARCs. On the other hand, women who attended primary education (HR=1.32; 95%C: 1.02 – 1.72) and women who were not sure about their fertility intention had higher hazards (HR=2.11; 95%C: 1.28 – 3.46) to discontinue these methods.

Conclusion: Most LARC episodes were discontinued early. Desire to become pregnant and side effects were the main reasons for discontinuation. Age, parity, women involvement in decision making, educational status and fertility intention were found predictors of LARCs discontinuation. Family planning service providers should focus on fertility intention and side effects when counseling women for contraceptives. Improving women’s decision making power at a household level may decrease LARC discontinuation.

Keywords: IUD, implant, discontinuation, long-acting, Ethiopia, contraceptive use episode, hazards ratio, Gompertz