142nd APHA Annual Meeting and Exposition

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Antenatal family planning counselling and immediate post partum IUCD service increased overall IUCD and contraceptive Use

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Mukesh Sharma, MBA, Masters in Rural Development, Masters in population science (pursuing) , Family Health International (FHI360), UHI, Lucknow, India
Kanchan Srivastava , Monitoring and Evaluation, Foundation For Research in Health System, Lucknow, India
Anju Dadhwal, Ms , Urban Health, Urban Health Initiative, New Delhi, India
Rajni Wadhwa, MD , Urban Health Initiative, FHI360, New Delhi, India
Roli Seth, MBBS, DGO , Quality Assurance, FHI360, Lucknow, India
Gita Pillai, MPH , Family Health International, India, Urban Health Initiative (UHI)-India, New Delhi, India
Vivek Dwivedi , Urban Health Initiative Project, New Delhi-110003, India
Som Sharma, MBA , Urban Health Initiative Project, New Delhi-110003, India
Introduction: IUCD acceptance in Uttar Pradesh, India is low and contributes only 1.1% to contraceptive prevalence (AHS 2012). Facilities primarily provide interval IUCDs with most providers having no training or motivation to provide PP IUCD. Janani Suraksha Yojna (JSY) scheme attracted women to deliver in hospitals and provided an opportunity to expand access to immediate post-partum IUCD.   

Intervention: A trained and skilled counsellor was contracted-in to the district women hospitals and doctors received clinical training in PPIUCD insertion. Along with counselling a whole site training was also conducted for all facility based staff. 

Method: Data collected and analysed included the number of deliveries, women receiving antenatal counselling, PPIUCD acceptors, and interval IUCD. The percentage acceptance of PPIUCD among all women who delivered and the contribution of PPIUCD to total IUCD inserted were calculated.

Results: PPIUCD insertions increased from 509 in 2010 to 6,312 in 2013 in the same facilities. The percentage PPIUCD acceptance against delivery is also increase from 2.3% in 2010 to 9.3% in 2013. It also resulted an overall increase in new IUCD clients from 5952 in 2010 to 13018 in 2013 (119%). Even there was no increase in interval IUCD clients between 2010 (4797) and 2013 (4535), PPIUCD contributed significantly to increase the total IUCD insertions.

Conclusion: The results indicate that the presence of a counsellor and counselling contract during the antenatal period, and skilled provider who can insert post placental IUCD at the time of delivery are key to increase access and acceptance of PP IUCD.

Learning Areas:

Administration, management, leadership
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Explain the key components of a focused post partum IUCD approach that resulted in increase in post partum IUCD insertions, and an increase in PP FP use. Explain how the PPIUCD helps facility to add new clients and increasing total number and coverage of IUCD clients in the facility.

Keyword(s): Public Hospitals, Advocacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a program manager for UHI project and all the data and reports are my responsibility. I have been a part of many studies and have presented the findings in different international forums.
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.

Back to: 3209.2: Exploring issues in contraception and family planning