Study identifies ways to increase IUD use in developing countries
Boosting demand for intrauterine devices, commonly referred to as IUDs, and improving access to them can significantly increase their use in developing countries, where they have traditionally been an unpopular method of birth control, a new study says.
Researchers at the nonprofit Population Services International and the Stanford University School of Medicine show how they were able to provide these long-acting, reversible contraceptives to more than a half-million women in 13 countries.
The group's "experience with promoting a contraceptive previously believed to be unsuitable for these contexts should encourage both public and private providers," the researchers wrote in their paper, which appears in this month's issue of Contraception.
Paul Blumenthal, MD, professor of obstetrics and gynecology and director of the Stanford Program for International Reproductive Education and Services, is the study's lead author. The other authors are with PSI, a Washington, DC-based organization dedicated to improving the health of people in the developing world.
Long-acting reversible contraceptives, such as IUDs, are known to be a safe, effective and inexpensive form of birth control. The IUD does not have widespread popularity, though: A 2005 United Nations report showed that IUDs were used by 7.6 percent of women of reproductive age in developing countries, compared to 14.5 percent of women in developed ones.
Experts believe there are a variety of factors that prevent more women in developing countries from using IUDs. Among others are "myths and rumors about the IUD, uncertainty or inadequate information about where a woman could get one, and an inadequate number of providers trained and ready to provide a quality service," Blumenthal said.
Women in these countries may face hurdles with other forms of birth control, as well. Access is common problem. "Clients often have to go a long distance to get their method, and even then might get to the clinic only to find out it's out of stock," said Blumenthal.
Project director Dana Tilson added, "When contraceptives are available in these settings, they are often limited to one or two options, all requiring frequent, repeat visits to continue."
In an effort to, in Tilson's words, "give women access to a range of choices that were previously unavailable" and to improve reproductive health, the researchers launched a two-year, 13-country initiative to promote and provide IUDs.
The project began in 2009 and focused on Cambodia, El Salvador, Guatemala, India, Kenya, Madagascar, Myanmar, Nepal, Nicaragua, Nigeria, Uganda, Tanzania and Zambia. The countries were chosen, Blumenthal said, because of their low IUD usage numbers, and because PSI identified them as areas with opportunities for significant improvement.
The initiative focused on both creating demand and improving service delivery. A group of community "mobilizers" conducted outreach in many of the countries, going door to door or arranging group meetings to educate women on family planning options and linking them with local providers. Media activities, including radio and TV spots, printed educational materials and billboards, were also done in many areas to address misconceptions about reversible contraceptives and to educate women on the potential benefits of using them.
Project leaders also improved access by training local clinic staff on counseling, complication management, side effects, removals and referrals, and by offering IUD insertion at a variety of clinics throughout each of the countries. Outreach clinic event days were held in six countries, during which IUD insertions were offered to local women over a one- to three-day period.
Between January 2009 and December 2010, 575,601 women across the 13 countries were provided with IUDs. The typical woman who received an IUD was in her 20s, married, had at least one living child and was primary-school educated. Twenty-four percent of women who received an IUD said they previously had been using no modern birth-control method.
Blumenthal believes a "success at this scale has not been previously reported." And he and his colleagues noted in the paper that the fact that so many women opted for an IUD indicates increased use is likely to occur "once barriers of provider training and negative perceptions of IUDS are overcome."
The authors also emphasized the importance of linking demand creation and service delivery. "By creating demand through 'marketing' but then also ensuring that there's a high-quality, reliable provider within easy reach of the client, we have shown that IUDs can be acceptable to women and provided at scale," said Blumenthal.
This initiative is ongoing, with the number of countries being expanded. Project leaders are now refining marketing approaches, focusing on providing IUDs to women immediately after they have delivered a baby, and working with various ministries of health to revise outdated guidelines, which will make access easier for women. Project directors are also turning their attention to post-abortion care, aiding women who have experienced unsafe abortions and ensuring they have access to contraception.
Journal reference: Contraception
Provided by Stanford University Medical Center
- IUDs reduce pregnancy rates compared to hormonal contraceptives Jun 15, 2010 | not rated yet | 0
- Immediate use of an IUD following abortion more likely to prevent unintended pregnancies Jun 08, 2011 | not rated yet | 0
- Long-acting contraception methods reduce repeat abortions Jul 25, 2011 | not rated yet | 0
- Consider IUDs for contraception, other conditions Apr 13, 2012 | not rated yet | 0
- Annual sonograms are needed to verify correct IUD position, obstetricians say Mar 29, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
gravity is std. therefore can we rate a 'mass at height' by watts?
2 hours ago For example.... wind turbines are primarily listed by their wattage (1.5MW etc.) Presumably their output is varied according to rotational speed, so...
Calculating on-axis elements of a solenoid
14 hours ago I wanted to mention that this solenoid has many winds over many layers. The thickness of the windings is 2.4 inches coming off of the engineering...
latitude & longitude & air pressure
15 hours ago Hi there, I have a peculiar question. Imagine that you are in a earth position, obtained by google, that gives you the latitude and longitude....
Differences of Classical Mechanics when learned with Calc vs algebra?
18 hours ago what are the differences? Every example I find usually has a derivative or integral or some kind of calculus defined concept that seems to make it...
what is the distance traveled
22 hours ago A rough sketch of experiment. Image: http://i43.tinypic.com/14t4sk5.png the red dots represent a side view of path traveled, F is downward force...
Image of a Convex Lens Cut in Half Horizontally
May 22, 2013 Hello everyone, A friend of mine came up with this question in class and I really do not have a good answer. Suppose you have a convex lens...
- More from Physics Forums - Classical Physics
More news stories
A study of around 1,000 UK mothers and their children, published in The Lancet, has revealed that iodine deficiency in pregnancy may have an adverse effect on children's mental development. The research raises concerns that t ...
Obstetrics & gynaecology May 21, 2013 | not rated yet | 0
Nearly three out of four pregnant women experience constipation, diarrhea or other bowel disorders during their pregnancies, a Loyola University Medical Center study has found.
Obstetrics & gynaecology May 20, 2013 | not rated yet | 0
New research indicates that women's reproductive function may be tied to their immune status. Previous studies have found this association in human males, but not females.
Obstetrics & gynaecology May 17, 2013 | not rated yet | 0 |
Elsevier today announced the publication of a recent study in Reproductive BioMedicine Online on 5-day old human blastocysts showing that those with an abnormal chromosomal composition can be identified by the rate at whic ...
Obstetrics & gynaecology May 16, 2013 | not rated yet | 0
While global attention has for decades been focused on reducing maternal mortality, population-based data on other causes of death among women of reproductive age has been virtually non-existent. A study conducted by researchers ...
Obstetrics & gynaecology May 14, 2013 | not rated yet | 0
A known difficulty in fighting influenza (flu) is the ability of the flu viruses to mutate and thus evade various medications that were previously found to be effective. Researchers at the Hebrew University of Jerusalem have ...
13 minutes ago | not rated yet | 0 |
Nervous about that upcoming job interview? You might want to take steps to reduce your jitters, especially if you are a man.
3 seconds ago | not rated yet | 0
22 May 2013, Paris, France: The Lotus Valve, a second-generation transcatheter aortic valve implantation (TAVI) device, was successfully implanted in all of the first 60 patients in results from REPRISE II reported at EuroPCR ...
15 minutes ago | not rated yet | 0
A potentially ground-breaking human drug trial is currently underway, which aims to discover whether blood pressure medication can slow or halt the progression of Alzheimer's Disease (AD). This is the latest ...
24 minutes ago | not rated yet | 0
Scientists at Newcastle University have shed new light on how the brain tunes in to relevant information.
1 hour ago | 5 / 5 (1) | 0 |
Professor Michael Jennings, Deputy Director of the Institute for Glycomics at Griffith University, was part of an international team that discovered the previously unknown pathway of how the bacterium colonizes people.
1 hour ago | 5 / 5 (1) | 0 |