Background: Long-acting reversible methods of family planning methods are assumed to be safe and highly effective and it serves the need of the users for a long period of time. In Ethiopia, despite the huge investment being incurred in these commodities by the government and partners, a premature removal of these Long-acting Reversible Family Planning (PR-LARFP) method has been increasing or not decreasing as expected. Therefore, the purpose of this study was to assess the perceived level of premature removal of LARFP methods and its implications on LARFP service delivery in Ethiopia.

Method: A qualitative study was employed in seven selected regions and city administration including Oromia, Somali, Afar, Gambela, Harar, Addis Ababa and Dire Dawa based on the level of premature removal of LARFP from the Health management information system (HMIS) report of the Federal Ministry of Health. We conducted 81 in-depth interviews and key informant interviews with women who had prematurely removed a LARFP method, women who adhered to using the LARFP method, family planning providers, husbands, community influential, and family planning key stakeholders from various organizations with different levels of involvement. The tape-recorded interviews were transcribed and translated in to English. The transcripts were coded and analyzed using the QCAmap2020 software. The inductive content analysis was conducted in which subcategories were grouped under identified outstanding categories.

Results: Study participants noted that premature removal of LARFP methods has been increasing, and to a certain extent, has become an emerging problem on the family planning service provision encounters. The implication of premature removal of LARFP methods identified were its negative impact on the intention to use the method in the future, discouraging other users, cost, impact on provider motivation and workload, eventually compromising the quality of service delivery.

Conclusion: Although LARFP utilization is being improved, premature removal of LARFP methods is claimed as blurring the achievements. The implication of the premature removal of the LARFP method ranges from the impacting on clients’ future intention to use the method to the level of compromising the overall family planning service delivery. This study has affirmed that premature removal of LARFP methods is posing several challenges to the country's plan to provide quality and sustainable family planning services. The impacts of premature removal of LARFP methods are multifarious that require interventions by diverse sectors.