Assessing the implementation of long-acting reversible contraceptive implant, Implanon NXT, roll out in East London, Eastern Cape, South Africa.

Background: In 2014, South African Department of Health (SADOH) initiated use of Implanon NXT, a type of implant in addition to long-acting reversible contraceptives available in the country to expand contraceptives options for women of reproductive age. After its introduction, there were reports on early removals and frequent side effects. It is therefore vital to identify how successful the implementation of this method was in particular in East London area. Objectives: The purpose of this study was to evaluate how successful the implementation of Implanon NXT roll out was in East London, Eastern Cape. Additionally, the study also aimed to understand the views health care providers have of the Implanon NXT. Methods: A retrospective crosssectional design using existing data from family planning registers and distribution of questionnaires to Health Care Providers responsible for insertion and removal of the method (HCP). Results: February 2014 to March 2019, 1238 Implanon NXT insertions were done and only 266 removals in one study site. Out of the 266 participants, 67.7% of the participants removed the Implanon for reasons other than ill health (side effects), while the remaining 32.3% had experienced side effects and opted for early Implanon removal. Bleeding was the most common side effect reported by 44 of 266 (16.5%) participants. The health care providers who completed questionnaires for this study were overall confident in providing the Implanon NXT services. Conclusion: Implementation of a new contraceptive method requires clear standardised policies and guidelines on counselling and management of side effects. Findings of this study are reassuring that Implanon NXT had a role to play in prevention of unintended pregnancies. Implementation and rollout in one site reviewed has been demonstrated to be successful. The respondents in this study possesses knowledge about the Implanon NXT