Studying the impact and performance of institutionalizing immediate post-partum IUD services as a routine part of antenatal counselling and delivery room services in Sri Lanka, Tanzania, and Nepal.
The International Federation of Gynaecology and Obstetrics (FIGO) has designed and is planning to implement, through its nationally-affiliated Associations of Gynaecologists and Obstetricians, an intervention program on post-partum IUD (PPIUD) services. As part of this Program, FIGO is responsible for information material, training providers, improving facilities, quality of service, and monitoring the program. Independent of the implementation, this study will measure the impact and performance of this intervention in three (Sri Lanka, Nepal and Tanzania) of the six countries participating in the FIGO project entitled: "Institutionalization of immediate post-partum IUD (PPIUD) services as a routine part of antenatal counselling and delivery room services in Sri Lanka, Kenya, India, Tanzania, Nepal and Bangladesh." The FIGO intervention will take place over a nine-month period in Tanzania (nine months in the first group of three hospitals and three months in the second group of three hospitals), and over a fifteen-month period in Nepal and Sri Lanka (fifteen months in the first group of three hospitals and nine months in the second group of three hospitals). Investigators will study both the impact of the intervention on the uptake and subsequent continued use of PPIUD and the extent to which the intervention leads to the institutionalization of postpartum IUD services in the hospitals during and after the FIGO intervention and to what extent the service diffuses to other hospitals or providers. The institutionalization and diffusion of the intervention will be measured by interviewing and following up trained providers, review of hospital records and baseline, during intervention and post-intervention facility surveys.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
140,258
The PPIUD intervention aims to address the postpartum contraceptive needs of women by training community midwives, health workers, doctors and delivery unit staff in postpartum IUD counselling and insertion.
Center for Research on Enviornment Health and Population Activities
Kathmandu, Nepal
Sri Lanka College of Obstetricians and Gynecologists
Colombo, Sri Lanka
Management and Development for Health
Dar es Salaam, Tanzania
Percentage uptake of PPIUD
To ascertain what percentage of women delivering in study hospitals take uptake PPIUD, participants will be interviewed after delivery, before they are discharged from the hospital.
Time frame: Within approximately 24 hours postpartum, before discharge from the hospital.
Percentage of women receiving PPIUD counseling
To ascertain what percentage of women delivering in study hospitals receive counseling on PPIUD, participants will be interviewed after delivery, before they are discharged from the hospital.
Time frame: Within approximately 24 hours postpartum, before discharge from the hospital.
Percentage of PPIUD acceptors who have expulsions at 4-6 weeks postpartum
Participants who have not deliberately removed the PPIUD will be examined by providers at 4-6 weeks postpartum, and providers will report whether the PPIUD was expelled.
Time frame: 6 weeks postpartum
Percentage of women using modern contraception at 9 months postpartum
Participants will be interviewed at 9 months and asked whether they are using a modern method of contraception.
Time frame: 9 months postpartum
Percentage of women using modern contraception at 18 months postpartum
Participants will be interviewed at 18 months and asked whether they are using a modern method of contraception.
Time frame: 18 months postpartum
Percentage of women pregnant at 18 months postpartum
Participants will be interviewed at 18 months and asked whether they are pregnant.
Time frame: 18 months postpartum
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