268144 Introduction of postpartum IUCD (PPIUCD) services in public sector: Experience from India

Tuesday, October 30, 2012 : 8:45 AM - 9:00 AM

Somesh Kumar, Director Programs, India , Jhpiego, India, India
Vivek Yadav , Jhpiego, India, India
Saswati Das, Working as Senior Advisor: Clinical Services and Training, Jhpiego, India; recognized as 'International Training Expert' by Jhpiego, USA, has 20 years of experience in providing managerial and technical leadership in public health programs in India. , Clinical Services and Training, Jhpiego, India, New Delhi, India
Methods: To leverage the dramatic increase in institutional deliveries after the introduction of conditional cash- transfer scheme in India and for addressing huge unmet need for contraception in the postpartum period, Government of India (GoI) introduced IUCD services in immediate postpartum period in select facilities in 19 states of India in 2010. A multi-centric follow-up study is being undertaken in 9 states to assess the post-insertion outcomes of clients. Results: Within two years of initiation of the program, PPIUCD services have been established in > 50 facilities across 19 states of India, with the GoI now deciding to scale-up the services across India. >22,000 PPIUCD insertions have been conducted, with > 5% of women delivering in these institutions opting for PPIUCD as their choice of contraception. 30% of PPIUCD acceptors could be followed up after 6 weeks of insertion and follow-up study data demonstrates that almost 90% of women were found continuing with the IUCD at the time of follow-up. Expulsion rate among the clients is 3.2%, which is comparable to the expulsion rates of interval IUCD insertions. 4.5% of women reported infection post-insertion and 7% of women got the IUCD removed within first six weeks of insertion, the major reasons for removal being bleeding and abdominal pain. This calls for strengthening infection prevention measures and counselling services. Conclusion: Introduction of PPIUCD services in public-sector is an effective and scalable public health intervention for increasing the access to wider basket of contraceptive choices to the women in their postpartum period.

Learning Areas:
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
• Describe the preliminary programmatic results of the program to introduce PPIUCD services in India •Assess the post-insertion outcomes of clients opting for PPIUCD services

Keywords: Family Planning, Outcomes Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Intra Uterine Contraceptive Device

Qualified on the content I am responsible for because: Dr. Sood is a seasoned public health professional with more than 35 years experience in international health and development. She has strong RH technical expertise, extensive program management experience and is well recognized and respected in the field of maternal health and FP/RH in India and internationally.
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.