JHPIEGO in partnership with Save the Children, Constella Futures, The Academy for Educational Development, The American College of Nurse-Midwives and IMA World Health

Reinvigorating the PPIUCD in India

Dr. Rinku SrivastavaSIFPSA, India

2

Session Objectives

Understand the need for postpartum family planning in India

Describe the confluence of factors for which a strategy of postpartum IUCD is suggested

Understand the strategic approach to national expansion of PPIUCD

33

India: Birth-to-birth Intervals for past five years

Source: NFHS 2006N =39,215 births

44

India: Unmet Need across Postpartum Period and FP use among Sexually Active Women

N=1305 N=2374 N=2661 N=2168

Source: NFHS 2006

55

Family Planning Method Mix across Postpartum Periods

N=243 N=687 N=921 N=845

6

Opportunities for Strengthening PPFP & PPIUCD services:

10 fold increase in women delivering in hospitals due to Maternity benefit scheme (JSY)

CuT 380 A is effective long term reversible method- an alternative for sterilization for many women

Current national strategy for increasing IUCD uptake New advances and new understanding about IUCD with

low expulsion rate and cost effective

7

PPIUCD initiative in Uttar Pradesh

PPIUCD training initiated on pilot basis in 2008 by SIFPSA

Service Sites assessed and strengthened

ObGyn Department, CSMMU, Lucknow identified as training site for PPIUCD

Providers from District Women Hospital Jhansi & Allahabad trained and service being provided

TA provided by Jhpiego

8

Status of PPIUCD Services in U.P.

7 Faculty members at CSMMU, Lucknow trained as Master trainers by Jhpiego 5 Doctors trained & 4 Staff Nurses oriented from Jhansi and Allahabad

SN Site Total PPIUCD inserted1 CSMMU. Lucknow 245(Jan 09 –Jan 10)

2 District Women Hospital, Allahabad

124 (Aug 09-Jan 10)

3 District Women Hospital, Jhansi

12 (Aug 09-Jan 10)

Total 381

9

Service Delivery Statistics

10

Lessons Learnt…

Concentrated efforts are needed to generate demand for PPFF including PPIUCD services

Counseling services to be strengthened Follow up and tracking of PPIUCD clients to be

institutionalized Capacity building of trainers & service providers

including supportive supervision at the service delivery site critical

Strong Monitoring and Evaluation of services needed

11

Plan for Expansion in other states:

Beside Lucknow training sites created and trainers trained at Delhi, Mumbai and Jabalpur

Trainings of providers to role out in additional 12 states from March 2010

Use of standard training material Course notebook for Trainers Course Notebook for Learners Reference Manual Post Partum IUCD Standards for training and service site

Job aids ANC Counseling Guide- PPFP PPIUCD Pre insertion Screening

12

Postpartum IUCD- Summary

Safe, convenient & cost effective, reversible, long term birth spacing method

Should be part of a maternal/newborn/ reproductive health package

JSY is an opportunity to add PPIUCD into FP program and could address the high unmet need for FP in India