Introduction of the injectable contraceptive NET-EN into family planning clinics in Bangladesh

In preparation for introducing the injectable contraceptive norethisterone enantate (NET-EN) into the national family planning programme, a field study was conducted in six family planning clinics in Bangladesh. A total of 913 women elected to receive injections of NET-EN every 8 weeks for 6 months and every 12 weeks thereafter. At 12 months of follow-up, the overall discontinuation rate was 37.3 per 100 women, the most common reason for discontinuation being bleeding disturbances. Marked differences in continuation rates in different centres pointed out the need for further research into clinic characteristics that may affect acceptance and continuation rates. Problems encountered during the study helped to pinpoint service delivery issues that need to be considered when introducing NET-EN into a family planning programme, including the need for thorough training of all clinic staff, adequate supplies of NET-EN, and provision of alternative methods of contraception for women who may not be able to return for the next scheduled visit.