Natural family planning in Mauritius, Indian Ocean: utilization patterns and continuance predictors

Factors associated with discontinuation from an island-wide natural family planning program in Mauritius were examined in 2 stratified random samples of 300 (1976) and 350 (1980) acceptors. The data were gathered through records, educator observations, and field interviews with the 1980 sample. Comparison between those served by the Action Familiale program and characteristics of the Mauritius population as a whole suggests that the natural family planning program serves a somewhat better educated group of couples who have more employment security and smaller families than the general population. Acceptors selected the natural family planning method for reasons such as a desire to have a child according to a plan or to space children (29%), avoidance of the side effects of artificial contraception (21%), or as a result of a recommendation by a friend, relative, or professional (25%). 74% of acceptors in the 1980 sample expressed satisfaction with the method and indicated that their spouse shared this satisfaction. After 3.5-4.5 years of follow-up, 57% of acceptors in the 1976 sample had discontinued use of natural family planning. 9 variables in 4 categories--Administrative, Psychological-Motivational, Educator-Acceptor Relationship, and Family--were predictive of discontinuation. The major factors differentiating discontinuers from continuers were: 1) discontinuers had previously registered at Action Familiale and dropped out; 2) discontinuers placed more emphasis on spacing than on preventing pregnancies; 3) discontinuers discussed fewer topics with their educators; 4) discontinuers and their husbands seemed less interested in the natural method; 5) discontinuers had less family support for natural family planning; 6) educators experienced greater difficulty in teaching discontinuers; 7) discontinuers demonstrated less understanding of the symptothermal method; and 8) educators made fewer preregistration visits to the homes of discontinuers.