Providing PPIUD service adds a valuable, long-acting method to postpartum family planning (PPFP)—one that can be provided after informed and voluntary choice through counseling and decision-making during antenatal care or pre-discharge. Counseling on PPFP methods should ideally begin in antenatal care, or be taken up (and reconfirmed if started antenatally) in labor or immediately postpartum. There are options for modes of insertion from post-placental to within 48 hours postpartum ,or even placed during a cesarean section. The use of a good insertion technique, facilitated by the right instruments, can result in low expulsion rates and offers a safe and acceptable method for both spacing and limiting pregnancies.
MCHIP built on ACCESS-FP efforts to develop and make more accessible resource materials for implementing PPIUD services in the context of PPFP programs. The PPIUD Working group was continually expanding a section of the PPFP Toolkit that pertains specifically to programming for PPIUDs. Offering demonstration and information in international conferences helped to galvanize interest. Furthermore, programs in several countries successfully initiated services, with some countries (such as India) going to scale. In 2013, a regional meeting of African countries sought to foster south-to-south exchanges to further accelerate expansion of PPIUD services in 10 countries.
- Stakeholder engagement and advocacy for initiating and/or scaling up PPIUD services at global and country levels
- Selecting and assessing high volume maternities as potential PPIUD program sites and engaging with champions and leaders in those maternities
- Offering competency-based training of service providers both in counseling for PPFP and in offering high-quality insertion services
- Tracking women post-insertion to monitor rate of side effects and complications.
PPIUD services were initiated in more than 15 countries. As a result, women who elected to give birth in those facilities had an option for a long-acting, highly effective, and “forgettable” method of contraception to meet their reproductive health needs. A Program Learning document synthesized key program lessons from multiple country experiences.