Figures & Tables
Figures
- FIGURE 1.
Population Services International’s Theory of Change for Implementing Complementary Public‐ and Private‐Sector IUD Interventions
Abbreviations: CPR, contraceptive prevalence rate; FP, family planning; IUD, intrauterine device; LARC, long‐acting reversible contraceptive; ToT, training of trainers.
A family planning client at Kawoko Muslim Health Centre in Kawoko Town, Uganda, holds an IUD while a midwife counsels her about the method.
- FIGURE 2.
Intervention Strategy in the Public Health System in Guatemala to Increase Public Provision of IUDs Within an Informed Choice Context
Abbreviations: CNAA, National Contraceptive Commodity Security Committee; IPC, interpersonal communication; IUD, intrauterine device; LARC, long‐acting reversible contraceptive; MSPAS, Ministry of Public Health and Social Welfare; PPIUD, postpartum intrauterine device; RH, reproductive health.
- FIGURE 3.
Uganda Sustainability and Scale‐Up Plan to Transition the Public-Sector IUD Intervention Package to the Ministry of Health
Abbreviations: IUD, intrauterine device; MOH, Ministry of Health; PACE, Programme for Accessible health Communication and Education.
Tables
- TABLE 1. Unmet Need for Family Planning, Contraceptive Prevalence Rates, and Source of IUDs Among Married Women of Reproductive Age in PSI Pilot Countries, 2008–2013
Guatemala 2008–2009 Laos 2011–2012 Mali 2012–2013 Uganda 2011 Unmet need 20.8% 19.9% 26.0% 34.3% CPR for all modern methods 44.0% 42.1% 9.9% 26.0% CPR for IUDs 1.3% 1.6% 0.4% 0.5% CPR for implants NAa 0.1% 2.5% 2.7% IUD source Public sector 51.8% 80.2% 78.3% 38.9% Private/NGO sector 46.2% 16.2% 21.7% 50.4% Other sector/missing 2.1% 3.6% 0% 10.6% Abbreviations: CPR, contraceptive prevalence rate; IUD, intrauterine device; PSI, Population Services International.
↵a Implants are included in the “other methods” category in the 2011 Guatemala survey.
Sources: Country household surveys.12-15
Service Delivery Quality Commodity Supply Chain Demand Policy Guatemala IUD and infection prevention equipment available in maternity and district hospitals; limited PPIUD equipment and gaps in provider IUD/PPIUD skills Low levels of IUD procurement at the national level Some demand for interval IUD services; little demand for PPIUD services LARCs not included in the national family planning strategy;PPIUD not in the national guidelines for hospital providers Laos Average of 8 years since last IUD training among public family planning providers Challenges in provincial forecasting and delayed transport of contraceptives to the provincial level resulted in IUD stock-outs 72% of women had heard of IUDs; high prevalence of myths and misconceptions 2012 moratorium on IUD service delivery in the private sector;lack of national LARC strategy Mali 59% of public-sector family planning providers in surveyed facilities had never inserted an IUD Inconsistent IUD availability at the health center level 53% of women had never heard of IUDs; high reluctance to undergo an IUD procedure that they considered invasive IUD service delivery restricted to doctors and selected midwives;lack of national LARC strategy Uganda 65% of surveyed public facilities had at least 1 provider trained in IUD insertion; limited IUD insertion equipment Lack of district supply monitoring mechanism linked to stock-outs at secondary health facilities 70% of women were aware of IUDs; low IUD demand attributed to myths and misconceptions Inactive family planning commodity security working group Abbreviations: IUD, intrauterine device; LARC, long-acting reversible contraceptive; PPIUD, postpartum IUD.
- TABLE 3. Geographic Intervention Areas With Supported Public Facilities, as of December 2014
Country Geographic Intervention Areas Supported Public Facilities (N = 417)a Guatemala 17 of 22 departments 24 Laos 10 of 17 provincesb 82 Mali 4 of 9 regions 189 Uganda 20 of 111 districts 122 ↵a The number of supported public facilities generally increased over time, with minor fluctuations between January 2013 and December 2014 due to intervention roll-out plans. Not all identified facilities began receiving support at the same time, and some facilities did not respond during data collection rounds conducted at multiple time points. The number of supported public facilities reported in this table and in the article is as of December 2014.
↵b Two fully covered intervention provinces, as well as limited intervention in 7 additional provinces (1 hospital per province) and several central hospitals in the capital.
- TABLE 4. IUD Insertions by PSI-Supported Private- and Public-Sector Providers by Country, 2011–2014
Country Private-Sector Providers Public-Sector Providers 2011 2012 2013 2014 Country Total 2011a 2012a 2013 2014 Country Total Guatemala 6,876 11,876 12,607 14,831 46,190 - - 830 3,719 4,549 Laosb 240 657 199 0 1,096 - - 906 6,812 7,718 Mali 1,608 5,999 8,326 8,219 24,152 - - 8,662 9,906 18,568 Uganda 23,403 45,589 40,573 36,666 146,231 - - 12,495 58,725 71,220 Annual total 32,127 64,121 61,705 59,716 217,669 - - 22,893 79,162 102,055
