An assessment of Norplant® removal in Indonesia

From 1987 to 1997, approximately four million Indonesian women had a Norplant® insertion. Concerns have been raised about the timely removal of the implant within a few days of the user's request or at the end of the recommended five years of use and about the possibility of a large and rapidly increasing backlog of removal cases developing. This study of 2,979 Indonesian women in 14 provinces, all of whom had had Norplant inserted five or more years before they were interviewed, reveals that 66 percent had obtained removal by the end of the fifth year of use and 90 percent had done so by the end of the sixth year of use. The data from this study strongly suggest that no large backlog of removal cases exists, particularly after the sixth year of use. The major reason for the underreporting of removals is probably clients' use of nurse/midwives, of caregivers in the private sector, and of mass safari camps, because records from each of these sources are poor or nonexistent.