The Rural Service Delivery Program (RSDP) delivers an essential services package (ESP) to a catchment population of 2.2 million eligible families throughout rural Bangladesh. The ESP includes the provision of FP/RH, MCH, and general health services through village depots and satellite and static clinics.
In order to provide a range of FP options to rural women, RSDP has “upgraded” nearly 300 satellite clinics to offer IUDs. Although most of the satellite clinics have no electricity or running water, RSDP has devised innovative strategies to provide women with quality IUD services. A regular table is transformed into an examining bed, specially designed curtains are used to ensure privacy, and autoclaves have been designed to sterilize IUD insertion equipment. An internal referral system is in place so Depotholders can refer clients to the upgraded clinics in neighboring villages. Depotholders conduct follow-up with IUD clients one month after insertion and advise them on side effects.
IUD use in RSDP areas has increased nearly 4-fold since 1997 from 2,100 to 9,500 IUDs per 6-month period, but still accounts for just 2% of total contraceptive use. With increasing numbers of upgraded satellite clinics, IUD distribution has increased 63% in the last one year.
Conclusions: There is a demand for high-quality clinical FP services in rural Bangladesh. The provision of IUD services is possible in rural settings with little infrastructure. Behavior change communication (BCC) strategies and effective systems of referral and follow-up are crucial to increasing the use of clinical contraceptives in rural settings.
Learning Objectives: By the end of the session, participants will be able to:(1) describe innovative ways to offer quality IUD services to women in rural areas; (2) identify some of the challenges and solutions to ensure infection prevention and privacy while offering IUD services in rural settings; (3) develop follow-up and side-effect management plans to decrease drop-out of rural IUD users.
Keywords: International Family Planning, Challenges and Opportunities
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.