From 1987 to 1997, approximately four million Indonesian women had a N
orplant(R) insertion. Concerns have been raised about the timely remov
al of the implant within a few days of the user's request or at the en
d 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, rev
eals 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 r
emoval cases exists, particularly after the sixth year of use. The maj
or reason for the underreporting of removals is probably clients' use
of nurse/midwives, of caregivers in the private sector, and of mass sa
fari camps, because records from each of these sources are poor or non
existent.