In-service training can be used either to transfer knowledge and skills about IUDs to providers who did not get this in their pre-service education or to update the knowledge and skills of providers currently providing IUD services (refresher training). This document provides guidelines that will increase the effectiveness of either type of training.

Suggested use: Use this worksheet to collect and organize data about each cadre of health care provider who will participate in the training. Collects information on such topics as their job descriptions; reading and writing levels; educational background and work experience; familiarity with computers and exposure to teaching/learning technology. 

Linking training to on-the-job performance is very important for ensuring that the participants apply the knowledge and skills acquired during the training when they return to their jobs. This sample action plan helps providers think about how to apply the new knowledge and skills achieved during training to their jobs. The training follow-up form is intended to document the number of participants who apply their new skills on the job, who retain their skills competency post-training, and the existence of factors limiting the use of participants’ skills on the job. 

Reorganizing skills among cadres is called task shifting (moving skills from one cadre to another) or task sharing (increasing the number of cadres able to perform a skill). Based on a review of the literature and country examples, the brief describes why task shifting is important and highlights some key steps in planning for, developing, and supporting cadres involved in task shifting. The guidance in this brief can be applied to task sharing for IUD programs, which is needed to meet the high demand demonstrated by IUD programs.

In response to the resurgence of interest in the IUD, this reference manual and associated courseware provide the latest essential information to clinicians, clinic managers, and clinical trainers to improve the quality of IUD services available. This package is meant to be used to provide competency-based training to service providers. Request a copy of this document: Send an e-mail message to orders@jhpiego.net.

Pathfinder International’s Intrauterine Devices (IUDs), Second Edition, is designed to train physicians, nurses, and midwives in contraceptive counseling, the advantages and disadvantages of the IUD, eligibility criteria for its use, and insertion and removal of the IUD. It actively involves participants in the learning process through simulation skills practice, discussions, and clinical practice, using objective knowledge, attitude, and skills checklists.

The purpose of this module is to meet the continuing educational needs of family planning practitioners, program managers, and policy makers in resource-constrained settings by providing up-to-date, evidence-based information on the IUD. Topics covered include a general overview of the IUD, client screening and counseling, insertion guidelines, and general managerial concerns related to IUD provision.

Although the primary infection concern during insertion of IUDs is pelvic inflammatory disease (PID), the risk of PID attributable to the IUD is considerably lower than believed.  The risk relates to progression of gonorrhea or Chlamydia infection present in the cervix at the time of insertion and not to the IUD itself.  Infection Prevention (IP) procedures have little or no effect on the course of gonorrhea or Chlamydia infections; nonetheless good IP practice is important in helping protect both clients and providers from infection in general.

Marie Stopes International (MSI) offers several training aids which can be used during instruction on IUD insertion and removal. The "Gynaecological Simulator 'Zoe,'" the "Pelvic Training Model," and the small and inexpensive "Hand Held Uterus Model" are all useful tools. They can be ordered through the MSI Web site. For more information on any of the training aids, please contact the procurement and logistics team at MSI: orders@mariestopes.org.uk  

This tool provides detailed instructions for processing instruments, gloves, and other items used for IUD insertion and removal to prevent infections. Reprinted, with slight modifications, from JHPIEGO. IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, 3rd edition. Adapted from: Tietjen, L. Bossemeyer, D. and McIntosh, N. (2003). Infection Prevention: Guidelines for Healthcare Facilities with Limited Resources. JHPIEGO, Baltimore, Maryland.

This tool provides tips to prevent infections during IUD insertion and removal, including selecting the appropriate setting and attire for clients and staff, as well as specific infection prevention measures to take before, during, and after the insertion and removal procedures. Reprinted, with slight modifications, from JHPIEGO. IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, 3rd edition.

This tool provides detailed instructions for inserting a loaded IUD into a woman's uterus. Reprinted, with slight modifications, from JHPIEGO (2006). IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, 3rd edition. Baltimore, Maryland. Adapted from: Program for International Training in Health (INTRAH). (1993). Guidelines for Clinical Procedures in Family Planning: A Reference for Trainers. INTRAH, Chapel Hill, North Carolina.

This tool provides detailed instructions for loading the regular Copper T 380A IUD in the sterile package. Reprinted, with slight modifications, from JHPIEGO (2006). IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, 3rd edition. Baltimore, Maryland. Adapted from: Program for International Training in Health (INTRAH). (1993). Guidelines for Clinical Procedures in Family Planning: A Reference for Trainers. INTRAH, Chapel Hill, North Carolina.

This tool provides detailed instructions for loading the Safe Load Copper T 380A IUD in the sterile package.  Reprinted, with slight modifications, from JHPIEGO (2006). IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, 3rd edition. Baltimore, Maryland. Adapted from: Program for International Training in Health (INTRAH). (1993). Guidelines for Clinical Procedures in Family Planning: A Reference for Trainers. INTRAH, Chapel Hill, North Carolina.

This tool provides detailed instructions for sounding the uterus. Reprinted, with slight modifications, from JHPIEGO (2006). IUD Guidelines for Family Planning Service Programs: A Problem-Solving Reference Manual, 3rd edition. Baltimore, Maryland. Adapted from: Program for International Training in Health (INTRAH). (1993). Guidelines for Clinical Procedures in Family Planning: A Reference for Trainers. INTRAH, Chapel Hill, North Carolina.

This document provides a brief overview of the ACQUIRE Project’s approach to training under theoverall ACQUIRE Program Model for FP/RH Service Delivery. This model of training reflects a comprehensive and holistic view that considers both the systems in which training and services are provided and the larger social and political context that affects service delivery.

This resource package contains essential information and tools for training health care providers in reproductive health and family planning (RH/FP). It is intended for use by: (1) program managers and staff implementing RH/FP programs; and (2) trainers in RH/FP service delivery. It provides an overall approach to programming for training, as well as information, methods, and tools for designing, developing, planning, implementing, and evaluating training. The package also provides tools and information for strengthening training systems.

A practical toolkit of related job aids intended to help service providers, trainers, service program managers, managers and members of community-based organizations, policy makers, and donors support individuals in making informed and voluntary family planning decisions. This practical toolkit has four sections:

Presents useful training tips, such as creating a positive training environment and opening activities.

Effective training can help family planning providers improve their service delivery performance. Intended for anyone involved in the management, design, delivery, or evaluation of group-based training, this handbook describes the steps necessary at each training stage to ensure a high-quality training course.

Clinical knowledge and skills are critical factors in sustaining quality health care services. However, there are many factors which influence the ability of providers to apply these skills when offering services. This handbook shares strategies and techniques that those involved in training or performance improvement efforts can use to support the transfer of knowledge and skills to on-the-job performance.

Student Learning Centers, also known as learning laboratories or demonstration rooms, are places where learners in pre-service education can observe demonstrations with models, practice together with models and/or role plays and develop skill competency. The following document is from JHPIEGO’s Breast and Pelvic Examination Learning Package, yet the information about such learning centers can also be applied to IUDs. 

Based on the concepts and principles presented in this paper, the key features of JHPIEGO's approach to training include:

The IUD is one of the most popular and effective methods in the world, with many positive attributes. Yet in many countries, IUDs are not widely used. This course will help you understand what can be done to revitalize IUD use, recognizing the importance of an informed user's choice of contraceptive methods. To access the online course, go to the Global Health E-Learning Center and register for free.