This assessment tested a model to train nurse auxiliaries at Guatemalan health centers and posts to determine whether these providers could deliver adequate, cost-effective services. Ninety providers were trained and delivered a total of 725 IUD services (measured over of two 12-month phases). The overall number of IUD services increased, as did the couple-years of protection for IUDs.  The quality of services provided by trainees improved over time and the main recommendation derived was to scale up the strategy nationally.

This case study summarizes the experience in Guatemala where a training program was launched certifying nurse auxiliaries to offer IUD services (both insertion and removal), take pap smears, and provide the DMPA injectable.  The results were encouraging, with IUD insertions rising dramatically during the course of the intervention.

Nurse auxiliaries who work at the rural health centers of the Honduran Ministry of Health (MOH) are frequently the only source of reproductive health services in the communities they serve.  In order to increase access to long-term family planning methods, the MOH and the Population Council conducted a study see if nurse auxiliaries could provide good quality IUD, Depo-Provera and vaginal cytology services without health risks for their clients.  The study concluded that auxiliaries could provide these services and that, in addition, the cost-effectiveness of the strategy was appr

Between 2008 and 2010, Marie Stopes International's (MSI) IUD provision in sub-Saharan Africa more than doubled. MSI provided 71,059 IUD insertions in 2008, 99,327 in 2009 and more than 167,000 in 2010.These figures demonstrate MSI’s growing success in increasing contraceptive choices and providing IUDs to underserved women in sub-Saharan Africa.

This is the final report of the three-phase project conducted by the ACQUIRE Project, in partnership with Guinea’s Ministry of Health (MOH), to increase access to and awareness of long-acting and permanent methods of family planning (LAPMs), particularly the intrauterine device (IUD), and to increase the MOH’s capacity to provide these services.

This brief presents The ACQUIRE Project’s conceptual model for IUD service provision and discusses the programming approaches that followed from this model. It includes summaries of some of ACQUIRE’s IUD-related activities, and discusses the challenges and lessons learned during implementation.

This case study describes the work of Save the Children and Family Health International (FHI) to reintroduce the IUD in the district of Mandiana, Guinea. The partnership focused on rais­ing awareness and support of IUDs, improving IUD services, and expanding access to services. Access to IUD services improved, and IUD insertions increased five-fold in four health facilities in Mandiana.

This brief addresses ACQUIRE’s work using the Supply-Demand-Advocacy model to promote the IUD in Ethiopia, focusing particularly on using communication for advocacy and to create demand.

This brief addresses ACQUIRE’s work using the Supply-Demand-Advocacy (SDA) model to promote the IUD in Guinea, focusing particularly on communications for demand creation and advocacy.

This brief addresses ACQUIRE’s work using the Supply-Demand-Advocacy (SDA) model to promote the IUD in Kenya, focusing particularly on using communication for advocacy and to create demand.

This brief addresses ACQUIRE’s work using the Supply-Demand-Advocacy model to promote the IUD in Uganda, focusing particularly on using communication for advocacy and to create demand.

This document presents the findings of a study on the effect of two factors: 1) simultaneous increase in IUD supply and demand; and 2) increased technical compentencies and counseling skills of providers on the use of IUDs in the Vadodara district of the state of Gujarat, India. Request a copy of this document: Send an e-mail message to publications@popcouncil.org or contact:

In 2001, encouraged by recent global findings on the safety of IUDs, including research conducted in Kenya on the safety of IUDs for HIV-positive women, the Kenya MoH, in collaboration with several other local and international partners, launched an initiative to promote increased client choice and a balanced and sustainable family planning program by reintroducing the IUD into the Kenyan method mix.  This case-study describes this reintroduction process.

This brief provides an overview of the work done by the Ministry of Health (MOH), the ACQUIRE Project, and others to revitalize the IUD in Kenya. Approaches, strategies, and activities are summarized, along with information about supply and demand.

Between 2008 and 2010, Marie Stopes International's (MSI) IUD provision in sub-Saharan Africa more than doubled. MSI provided 71,059 IUD insertions in 2008, 99,327 in 2009 and more than 167,000 in 2010.These figures demonstrate MSI’s growing success in increasing contraceptive choices and providing IUDs to underserved women in sub-Saharan Africa.

Over the last two decades, MSI has pioneered innovative approaches to reaching men and women with high quality contraceptive services. A promising model which reaches areas where traditional health services cannot reach is the use of mobile outreach health teams. The MSI outreach model generally consists of a team of nurses, healthcare assistants, counselors and a driver visiting rural, hard-to-reach areas and providing a range of high quality contraceptive services. In 2009, MSI provided services to over 1,200,000 men and women through its outreach services.

For the past 32 years, Marie Stopes International (MSI) has been working to close the gap between the need and availablility of long-acting and permanent methods (LA/PMs) by delivering these methods to communities with limited access to family planning services. In 2008, MSI delivered over 1.1 million LA/PMs through clinics, mobile outreach, and the BlueStar social franchise network of private health providers. 

This presentation provides information about Population Services International's approach in Cambodia to expand access and demand for long-acting family planning methods through mobile services. Mobile service delivery of IUDs and implants provided the opportunity to give on-the-job training to providers while also increasing access to clients. The presentation also provides results of the initiative and lessons learned. 

This presentation gives an overview of Population Services International's intervention in Kenya to increase uptake of IUDs and implants. The intervention involved developing a private-sector network of private providers, who were identified with a common logo. They agreed to promote long-acting methods, especially IUDs and implants and to adhere to quality service provision. In return, they were provided with training and other resources. The presentation presents the initiative's results, as well as successes and challenges of the model.

In 2003, the Kenya Ministry of Health, Division of Reproductive Health launched an IUD reintroduction initiative with the collaboration of over 18 international and local partners.  From 2003-2005, project partners designed and implemented a comprehensive program that addressed barriers to IUD use at all levels where needs had been identified: advocacy to policy makers and providers, provider clinical training, improved logistics and supplies, and community level education.  This case study describes the expansion of this IUD program in the Kisii district of Kenya.

This marketing case study details the experience of PSI and its Pakistan affiliate, Greenstar, in the development of a social franchise network of private doctors, paramedics, and pharmacists to increase access to reproductive health care, and specifically IUDs, by low-income Pakistanis.

In 2003, PSI/Nepal created the Sun Quality Health Network (SQH) to enhance the quality of family planning services in the private sector, and increase access to a range of methods, including IUDs.  This case study describes the marketing and social franchise model that has offered providers with opportunities for extensive training and on-going support and supervision in IUD provision.

The TAHSEEN integrated family planning and reproductive health model focuses on improving the quality of care, mobilizing the community, and ensuring long-term sustainability. TAHSEEN’s community-based model for provision of RH/FP services (including the IUD) involves training of providers, community mobilization, linkages to non-health programs, working with media, and enforcing the message through behavioral change and communication activities.

This case study summarizes the experience of the Green Star Service Delivery Network in Pakistan and specifically how this social franchising strategy was successful in expanding access to reproductive health services, specifically the IUD.

This presentation gives an overview of Population Services International's intervention in Zambia of seconding highly skilled, dedicated long-acting method providers to selected high-volume government facilities to improve access to and uptake of long-acting methods. In the first 12 months, the initiative served over 26,000 women with long-acting methods. The presentation provides advantages, challenges, and lessons learned about this particular model.

This brief provides information about Population Services International's approach in Mali to raise awareness among women of family planning methods, with a special emphasis on IUDs and implants. The women were reached at clinic immunization days for children under one year. The initiative provided the women with information about the methods and provided them with family planning services. The brief discusses challenges and lessons learned. 

This report aims to provide detailed information on the dynamics of IUD use in developing countries, using data from the most recent Demographic and Health Surveys (DHSs). More specifically, it provides the socio-demographic profile of IUD users, continuation of use and reasons for the discontinuation of use at 12, 24 and 36 months. In addition, it provides information on method-switching following discontinuation for method-related reasons.

To inform family planning programs and improve service delivery, Marie Stopes International/ Viet Nam collaborated with three provincial health departments to explore the dynamics of IUD use. A retrospective study was conducted among women who had received IUD services between 2006 and 2009 at commune health stations (CHSs) located in Thai Nguyen, Khanh Hoa and Vinh Long provinces. Researchers examined the socio-demographic profile of IUD users in these provinces and sought to describe discontinuation and method-switching behaviours.

A retrospective study was conducted in August 2009 to examine the rates of IUD discontinuation and reasons for removal among women who attended Marie Stopes International Philippines (MSI Philippines) IUD outreach services in June 2006, 2007, and June 2008.

This document presents the findings of a study on the use of IUDs in the Vadodara district of the state of Gujarat, India on the effect of two factors: (1) simultaneous increase in IUD supply and demand; and (2) increased technical compentencies and counseling skills of providers.

This final report presents an overview (including background, study methodology, and results) of the ACQUIRE Project/Bangladesh’s IUD discontinuation study. The study’s overall objectives were to quantify the outcomes of IUD use 12 months after insertion and to examine factors associated with IUD discontinuation in six districts of Bangladesh.

In spite of the advantages to the IUD, its use in relation to other contraceptive methods is reported to have either stagnated or declined in a number of countries, including Ghana. The reasons for this are not well understood.  Therefore, this case study addresses the following key questions: What client characteristics affect the demand for and use of the IUD? What are the provider and system characteristics that shape use of the IUD? What can be done to reduce barriers to the use of the IUD?

The purpose of this case study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health (MSPAS), the Guatemalan Social Security Institute (IGSS), and APROFAM.

This assessment report provides an example of the steps involved in identifying local and regional factors related to underutilization of the IUD. In response to stagnated levels of IUD use in Tanzania, descriptive data were collected to identify contributing factors at policy, community, organizational, training, and workforce levels. These findings were used to develop recommendations for increasing access to the IUD.

This document is a compilation of discussion guides used in Guinea to conduct focus group discussions and in-depth interviews on longer-acting and permanent contraception among women, men, service providers, and religious and community leaders.

Several instruments were developed to collect qualitative data on IUD services in Guatemala to help inform future directions for contraceptive promotion and supply. The instruments include an availability survey, simulated client checklists, in-depth interview guide with informants, and focus group discussion guides. Request a copy of this document: Send an e-mail message to frontiers@pcdc.org.

Several instruments were developed to collect qualitative data on IUD services in Ghana to help inform future directions for contraceptive promotion and supply. The instruments include a service provider instrument, simulated client study instrument, key informant guide, and focus group discussion guide. Request a copy of this document: Send an e-mail message to frontiers@pcdc.org.

This client questionnairre was used in an assessment that aimed to determine the reasons for the slow growth of IUD use in Kenya. In particular, the researchers wished to find out whether significant provider bias against the IUD existed in Kenya, and if so, to describe the nature and scope of these biases. This tool can be adapted as necessary for any future assessments.

This discussion guide for interviews with service providers was used in an assessment that aimed to determine the reasons for the slow growth of IUD use in Kenya. In particular, the researchers wished to find out whether significant provider bias against the IUD existed in Kenya, and if so, to describe the nature and scope of these biases. This tool can be adapted as necessary for any future assessments.