Key Elements and Inputs Intended for Implementation of the PPIUD Initiative in 6 Countries

Elements and InputsDescription
Training: “Train-the-trainer” model: Training cascaded from master trainers to existing eligible providers at selected health facilities


  • Prenatal counseling on available family planning methods with an emphasis on PPFP using standard training methods (e.g., GATHER model)

  • Included information on the advantages of PPIUD

  • Open discussion about providers’ views of PPIUD to address any prejudices

  • Role play, case scenarios

  • Providers encouraged to use counseling aids (e.g., leaflets, posters, flipcharts, and videos)

PPIUD insertion and removal:

  • Theoretical (classroom-based) training and practical sessions using Mama-U postpartum uterus models

  • Refresher trainings offered as needed

  • Regular training of new staff rotating in

Equipment and supplies
  • Mama-U models

  • Copper T IUDs

  • Long-handled 33 cm curved Kelly forceps

National coordination
  • Implementation was coordinated through national professional societies or colleges to encourage local ownership

  • National societies set up steering groups for clinical and technical guidance

Structures established to facilitate implementation
  • Dedicated project management team

  • Facility-level project coordinators

  • Data Safety Monitoring Committees

PPIUD counseling and insertion services delivered by trained providers
  • Integrated within existing maternity services

  • Prenatal counseling on all available contraception methods with an emphasis on PPFP, and the advantages of PPIUD as a safe, effective, and reversible long-acting method

  • Consent forms provided during prenatal visits

  • Stickers placed on women’s case files to identify consenting women at delivery

  • Women who did not receive prenatal counseling could be counseled during early labor or the postnatal period to ensure insertion within 48 hours if PPIUD was desired

Monitoring and evaluation
  • Data collection officers collected information on counseling, consent, PPIUD, and follow-up for women delivering in participating facilities

  • Abbreviations: GATHER, greet, ask, tell, help, explain, and return; IUD, intrauterine device; PPFP, postpartum family planning; PPIUD, postpartum intrauterine device.