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Midwives in Nicaragua learn about the IUD during a workshop. Midwives and other health workers besides physicians can provide IUD services safely and effectively when appropriately trained. (Photo: Catherine Richey/CCP, Courtesy of Photoshare)
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KEY POINTS
Modern intrauterine devices (IUDs) are safe, effective, and quickly reversible long-term contraceptives that require little attention after insertion. Yet safety concerns and programmatic challenges have held back IUD services in many countries. New assessment of research findings, recently translated into guidance by the World Health Organization, should help reassure providers that most women can use IUDs safely.
Some family planning programs now are giving the IUD new attention. Basic requirements for making high-quality IUD services available include:
- Service delivery guidelines updated by stakeholders to remove unnecessary barriers.
- Front line providers trained how and why to follow the guidelines and backed up with supportive supervision.
- A core group of IUD providers, well trained in IUD insertion and removal, counseling, and management of side effects and complications, who can maintain their skills by seeing a steady flow of clients. Competency-based training, which focuses on ensuring each trainee demonstrates competence, works best.
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- A referral system to assure that women who want IUDs can easily make contact with the core group of providers.
- Necessary infrastructure, equipment and supplies to provide high-quality IUD services. Low-resource settings can adopt innovative strategies to provide ongoing IUD services.
- Clients who are well informed about the IUD. Well-designed communication activities and helpful counseling increase people's understanding of the IUD and may reduce unfounded or exaggerated concerns.
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How To Use This Report
Family planning program managers can use this report to:
- Overcome perceived programmatic challenges to providing IUD services, including approaches to keep down costs (see 'Providing High-Quality IUD Services').
- Help assure good-quality care for IUD services. The checklist, "Program Plan for Providing High-Quality IUD Services," may be particularly useful (see 'Checklist: Program Plan for Providing High-Quality IUD Services').
- Answer questions from providers and policy makers about IUD safety, medical eligibility criteria, and programming needs.
- Be alert for common provider biases—and practices that come out of those biases—that unnecessarily limit IUD use.
Family planning providers can use this report to:
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