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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3246.0: Monday, December 12, 2005 - Board 1

Abstract #110981

Best practices for country programs in IUD provision

Ricardo Vernon, PhD1, Philomena Nyarko, PhD2, Harriet Birungi, PhD1, M.E. Khan, PhD3, and John W. Townsend, PhD4. (1) Population Council, Panzacola 62 - 102, Mexico City, 04000, Mexico, (52)(55) 5999-8630, rvernon@popcouncil.org.mx, (2) Navrongo Health Research Centre, P.O. Box 114, Navrongo, Ghana, (3) Population Council, Population Council, India, One Dag Hammarskjold Plaza, New York, NY 10017, (4) Frontiers in Reproductive Health, Population Council, 4301 Connecticut Ave., N.W, Suite 280, Washington, DC 20008

For reproductive health programs, the IUD offers effective protection against pregnancy, long-term continuation, and low commodity costs. However, 40 years of experience with the provision of IUDs has demonstrated that simply training physicians and supplying IUDs does not translate into client demand or effective service delivery. The failure of programs to sustain demand for the IUD is due to contraceptive market dynamics, poor use of evidenced-based training and supervision models, and the lack of skilled providers at multiple levels in the health system. For example, in Guatemala, low IUD use is still an issue of access. In Ghana, low use has more to do with lack of promotion, as few clients are aware of its availability. In India, the availability of sterilization in clinics and spacing methods through commercial networks has made the IUD an underutilized method.

Several models have demonstrated effectiveness in both urban facilities and rural districts. They include postpartum and postabortion IUD services, and services for women switching to the IUD from another method. Most models have depended on physicians as providers and use large referral networks such as CBD programs and private physicians. Increasingly, nurses and midwives also provide comprehensive IUD services with referral. This paper reviews the evidence from country case studies on the coverage, quality and cost of effective IUD service models, as well as the characteristics of IUD users and providers.

Learning Objectives:

  • At the conclusion of the session, the participants will be able to

    Keywords: Family Planning, Reproductive Health Research

    Presenting author's disclosure statement:

    I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

    Monitoring and Evaluation: Improving Family Planning and Reproductive Health Services

    The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA