207541 Programmatic Feasibilty of Post Partum IUD Provision in Zambia

Tuesday, November 10, 2009

Josselyn Neukom, MA , Society for Family Health, Zambia, Population Services International, Lusaka, Zambia
Jully Chilambwe, CNM , Society for Family Health, Zambia, Lusaka, Zambia
Nomsa Siamwanza, CNM , Society for Family Health, Zambia, Lusaka, Zambia
Reuben Kamoto Mbewe, MD , Deputy Director Reproductive and Child Health, Zambia Ministry of Health, Lusaka, Zambia
Bellington Vwalika, MD, MPH , Obstetrics & Gynecology Department, University Teaching Hospital, Lusaka, Zambia
Paul Blumenthal, MD , School of Medicine, Department of Obstetrics and Gynecology, Stanford University, Population Services International, Stanford, CA
Aleen Saunders, MIA , Reproductive Health, Population Services International, Washington, DC
INSTITUTIONS: Society for Family Health/Zambia, Ministry of Health/Zambia, Population Services International, University Teaching Hospital Zambia, Stanford Program for International Reproductive Health Education and Services

OBJECTIVE: Explore the feasibility post-partum IUD insertion (PPIUD) to increase IUD use in Zambia.

BACKGROUND: Less than 1% of all married women in Zambia currently use an IUD. Despite evidence of latent demand, access to IUD services remains limited. Prior to February 2009, PPIUD services were not available in Zambia.

METHODS: Advocacy with government officials, clinic administrators, providers and clients between November 2008 and January 2009, established support for the introduction of PPIUD services in Lusaka. In February 2009, 2 doctors and 9 midwives were trained in PPIUD during a one-week competency-based course. Post-training, the midwives resumed service delivery within UTH and two busy clinics in Lusaka. PPIUD clients were recruited through sensitization and counseling during ante-natal visits or among women who presented for induction, were in early stages of labor, or were immediately post-partum and expressed interest in PPIUD. Informed, voluntary consent was obtained in all cases.

RESULTS: Uptake of PPIUD services was significant. During the first two weeks the service was provided, 40 clients received PPIUDs at UTH and 2 urban clinics.

CONCLUSION: Advocacy with government officials and health providers, dedicated PPIUD providers at high volume clinics, PPIUD counseling for ante and post natal clients, and post-training support for PPIUD providers can increase use of IUDs.

Learning Objectives:
To evaluate the feasibility post-partum IUD insertion (PPIUD) to increase IUD use in Zambia

Keywords: International Family Planning, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a technical advisor in PSI's Reproductive Health Department based in Washington, DC and have been involved in the IUD program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.