ورقة علمية / Research Paper

Background Subdermal contraceptive implants (SCI) are highly effective long-acting reversible contraceptives, offering reliable pregnancy prevention. However, they may cause side effects, such as menstrual changes, hormonal effects, and local reactions, which can affect satisfaction and continuation. In Sudan, limited access to modern contraceptives and variable family planning services make it important to understand the demographic and health impacts of SCI use to improve uptake, satisfaction, and program effectiveness. Objectives Primary Objective: • Assess health outcomes and complications associated with SCI use among Sudanese women in Northern Sudan. Secondary Objectives: 1. Describe the demographic and reproductive characteristics of SCI users. 2. Determine the frequency and types of complications experienced. 3. Examine associations between complications and factors such as age, region, and reproductive history. 4. Evaluate user satisfaction and reasons for SCI removal or discontinuation. Methods and Materials Study Design and Setting A cross-sectional study will be conducted in family planning centers in Northern Sudan. Study Population and Sampling • Population: Women who have received an SCI at participating centers. • Sample Size: 700 women recruited using purposive sampling to ensure diverse representation. • Inclusion Criteria: Received an SCI and available for follow-up. • Exclusion Criteria: Incomplete records or inability to participate in interviews. Data Collection • Medical Record Review: Demographics, reproductive history, SCI use, removal, and documented complications. • Phone Interviews: Experiences, satisfaction, and unrecorded complications. Variables Assessed • Demographics: age, residence, living situation • Reproductive history: parity, inter-pregnancy interval • SCI outcomes: duration of use, removal reasons, complications, psychological effects Data Analysis • Descriptive statistics: frequencies, percentages • Inferential analyses: chi-square, odds ratios (OR), relative risks (RR), 95% confidence intervals (CI) • Significance: p < 0.05 • Software: Jamovi 2.3 Ethical Considerations • Informed consent will be obtained from all participants during phone interviews. • Participation is voluntary, and participants can withdraw at any time without affecting care. • Confidentiality will be maintained using unique codes, with data stored securely and accessible only to the research team.

All participants will be provided with clear information about the study’s purpose, procedures, potential risks and benefits, and their rights. Consent will be obtained during phone interviews, verbally or in writing depending on literacy levels. Participation is voluntary, and women can withdraw at any time without any effect on their access to healthcare.

Provides evidence to guide family planning programs on improving SCI service delivery and quality across different regions of Sudan. • Supports development of strategies for monitoring and managing SCI side effects, improving efficiency in resource allocation at family planning centers.