Information and Communication Technology Supports Implant Programs
Family planning programs with access to computers and Internet services can use information and communication technology (ICT) to help them introduce and manage contraceptive implants.
ICT Tools Can Help Train Providers in Implant Provision
A number of organizations have developed computer-based tools to help train providers in implant provision. These tools help providers develop competence with implant insertion and removal, improve their knowledge about the types of implants, and develop counseling techniques to help clients with continued use.
Organon. Where Implanon is available, Organon has held training programs to familiarize health care providers with all aspects of its use. Participants have the opportunity to practice insertion and removal techniques under professional guidance. In addition, Organon has developed numerous computer-based training materials in English, French, and Arabic. A CD-ROM with a PowerPoint presentation about Implanon gives a detailed scientific overview of the method. An accompanying clinician’s manual and product monograph cover these topics in more detail. Another CD-ROM provides an animated display of the anatomy of the arm where the implant should be placed and insertion and removal demonstrations, including both correct and incorrect insertions. Videos show actual insertion and removal procedures and how to locate hardto- find implants with ultrasound (67, 68, 69, 70, 71, 72, 73). For additional information, see http://www.implanon.md. For more information in French, see http://www.contraception.organon.fr.
Bayer Schering Pharma. Bayer Schering Pharma works locally with family planning programs around the world, offering support and technical expertise in providing Jadelle. The training programs use a CD-ROM showing both actual and animated insertion and removal procedures. A PowerPoint presentation on Jadelle for trainers and providers gives a detailed scientific overview of the method. All trainees receive a Jadelle Insertion Training Kit, which includes a card to help measure exactly where the rods should be placed in the arm, scalpel, trocar, forceps, and other supplies. A training manual and product monograph offers detailed information on the clinical profile of the method, bleeding characteristics, and insertion and removal techniques (4). To request materials, contact Bayer Schering Pharma Oy, PO Box 415, FI-20101 Turku, Finland.
JHPIEGO. JHPIEGO’s Internet resource collection Reproline contains a section dedicated to Norplant. The Norplant Web site offers information about the method, service delivery guidelines, and a PowerPoint presentation that gives a thorough overview of the method. The site also offers a PowerPoint presentation on managing bleeding problems, checklists for providers, and materials for training courses. The Norplant materials on the Web site are readyto- use resources for clinical trainers and resource managers. These resources can be used as visual aids or additional references for training, and they can be modified, adapted, and translated into local languages. The Web resources can be used in conjunction with a paper-based learning resource package that contains a reference manual and participant’s and trainer’s handbooks. As of August 2007 JHPIEGO is updating the Web site to reflect revised medical eligibility criteria as well as recent findings on effectiveness. These materials are also available on a CD-ROM (59). See http://www.reproline.jhu.edu/english/1fp/1methods/1ni/ni.htm.
Baylor College of Medicine. The Baylor College of Medicine provides a free online continuing medical education (CME) course on Implanon. The course covers the characteristics of the implant, common myths, and the benefits and side effects of the method. The course is presented in a PowerPoint format and is followed by a post-test (81). See http://www.contraceptiononline.org/slides/talk_cme_activity.cfm?tk=28&cmepage=cme_info .
Forecasting Tool Helps With Decision-Making
When countries and family planning programs consider adding contraceptive implants into their method mix, they should assess whether they have the capacity to deliver the method appropriately (60). The ACQUIRE Project has developed a planning package of evidence-based tools and approaches. The package includes Reality Check, a forecasting tool that helps national and district level staff to project family planning needs and plan realistically to meet them. Projecting contraceptive prevalence rates for each method is essential both to evaluate current efforts and to make plans for the future. This tool can be useful for considering the introduction of new implants. For example, Reality Check could forecast future levels of implant use, commodity needs, and costs of implants at the district and site level. This can help program managers assess whether they have the resources to meet the needs forecasted by Reality Check (1, 80, 101, 110). For additional information contact the ACQUIRE Project at info-acquire@acquireproject.org.
Computer-Based Tools Help Manage Supply
To ensure a smooth introduction or transition to new implants, maintaining sufficient supplies is essential. Pipeline Monitoring and Procurement Planning System (PipeLine), a PC database application developed by USAID through the DELIVER Project at John Snow Inc., generates the information needed to ensure timely receipt of products and to maintain consistent stock levels at the national and program level (50).
Basic computer skills are all that are required to use PipeLine. For each product, PipeLine tracks rate of consumption, shipments of new products, inventory levels, and inventory changes. Graphic displays help managers to estimate supply requirements. The program can predict pipeline problems, including shortfalls, surpluses, or stockouts (50). This tool can be useful for planning implant procurements. The PipeLine software can be downloaded directly from the DELIVER Project Web site at http://www. deliver.jsi.com. To request a copy of the PipeLine CD-ROM, email deliver_pubs@jsi.com.
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