TABLE 1.

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

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