Another Congress is complete and the FIGO HQ team would like to thank everyone who attended and contributed to the important conversations. It was fantastic to see the country teams interacting and learning from one another. Some of the key take away points were:
Optimal use of family planning and birth spacing could avert 32% of maternal deaths
In the year 2000, family planning could have averted 90% of abortion related and 20% of obstetric related mortality and morbidity
Conservatively 1 million of the 11 million deaths in children under 5 could be averted by ensuring that inter-birth intervals are no less than 2 years. Postpartum family planning can play a big role in achieving this.
Based on the experience so far, we believe that expulsion rates for PPIUD can dramatically decrease if providers are trained in the correct technique and have the correct equipment for insertion, especially ensuring use of the CuT 380A. Further evaluation is needed.
Good quality family planning counselling for women in the post-natal period is key to ensuring effective provision of services
Better advocacy efforts are needed to overcome health professionals’ misconceptions related to PPIUDs
There is a strong need for public promotion of the advantages of PPIUD
The PPIUD initiative is being implemented in Tanzania in 6 hospitals – Muhimbili, Mbeya, Tumbi-Pwani, Sekou-Toure, Dodoma and Mount Meru, well as their respective satellite clinics. As Tanzania is part of the Harvard research, all facilities will conduct 3 months of baseline data collection before the intervention arm of the project begins.
The Tanzania country team worked tirelessly to deliver a very successful training for their data collection officers from 7th-15th December. Thirty-eight DCOs were trained to use the CommCare app and conduct interviews.
The AGOTA and MDH teams also underwent training in problem solving and data exportation using CommCare HQ.
Baseline data collection started on Wednesday 16th December and will continue for three months followed by the start of the provision of services in the intervention arm and ongoing data collection.
Congratulations to all the country teams as this marks the completion of data collection training in all countries!
Data Collection Trainees watch their colleagues practice interviewing
A few key changes in training and implementation can dramatically reduce expulsion rates for PPIUDs. Ensure that you:
1: Use the proper instruments – The use of Kelly’s forceps ensures easier placement of the PPUID at the top of the fundus.
2: Use the correct IUD – Ensure that the Cu T380A (pictured top right) is used for postpartum insertion. One facility in the initiative reported that there was an increased tendency for expulsion when CU 375 (pictured bottom right) was used in the postpartum period. This may be due to the pliable wings and contractile postpartum uterus.
3: Adequate and repeated training – Facility coordinators should ensure that all staff are sufficiently trained to insert PPIUDs and that refresher training is given if providers are unsure of the right technique.
PPIUD Follow-Up - Dr de Caestecker Health professionals from all 6 countries contributed to FIGO’s research on PPIUD follow-up procedures. This has helped us to understand better the follow-up procedure for women who have a PPIUD but whose threads cannot be seen.
Watch this space as the full report will be shared soon.
CLELAND, J. SHAH, I and DANIELE, M. (2015) Interventions to Improve Postpartum Family Planning in Low and Middle Income Countries: Program Implications and Research Priorities. Available from http://onlinelibrary.wiley.com/doi/10.1111/j.1728-4465.2015.00041.x/abstract [Accessed 6th January 2016] Assesses strategies for implementing post-partum family planning in differing contexts.