Postpartum IUD Project: Bangladesh

mother and child image

“Choosing a method for myself, I needed a long-acting reversible method because I want to have another child in 5 or 6 years, I did not hesitate to choose PPIUD. It is also non-hormonal so I am able to breastfeed my baby, which is important to me.”

Najbin Akter, PPFP Counsellor at Khulna Medical College Hospital and PPIUD user

Globally, 214 million women have an unmet need for contraception. The postpartum period provides an excellent opportunity to initiate access to family planning.

To this end, in 2013 FIGO began the ‘Institutionalisation of Immediate Postpartum IUD (PPIUD) Services Initiative.’ It has trained community midwives, health workers, doctors and delivery unit staff in counselling on postpartum family planning (PPFP) and insertion of IUDs immediately postpartum.

We are proud to celebrate the impressive achievements of each of the countries involved in this project. For this article, we look at the success of the project in Bangladesh.

Background

FIGO’s PPIUD Initiative launched in Bangladesh in 2015, with the aim of strengthening the knowledge and skills of health providers (obstetricians and gynecologists, labour room nurses and midwives) in PPFP services. The initiative advocated for the sustained inclusion of PPIUD counselling and insertion into national services to sustain impact beyond the immediate project funding.

Between 2015 and 2020, the project has worked closely with facilities to:

  • improve effectiveness of PPFP information and counselling among clients attending antenatal and delivery services
  • strengthen the capacity (knowledge and skills) of health professionals
  • improve the quality of PPIUD service delivery by minimising complications
  • increase utilisation of teaching hospitals for practical PPIUD training by students in affiliated medical college hospitals and midwifery institutes
  • promote task-sharing by working with midwives to provide comprehensive counselling and insertion training
  • roll out training through the Obstetrical and Gynecological Society of Bangladesh OGSB regional branches for greater coverage.
  • embed data collection on PPFP and PPIUD into routine data-recording mechanisms at facility, district and regional levels to establish feedback loops
  • produce an effective and reproducible PPIUD service model that can be recommended to the government for scale-up nationwide.

Project Duration:      5 years (2015-2020)=

Partner Societies:     Obstetrical and Gynecological Society of Bangladesh (OGSB)

Key Stakeholders:    Regional OGSB branches; DGFP; Directorate of Nursing and Midwifery; DGHS

Number of Facilities: 6 referral hospitals

Key Data

Total providers trained on counselling and insertion: 2,762

Total counselled on PPFP, including PPIUD: 186,394

Total PPIUD insertions: 14,791

Related Publications

Full supplement available online in the International Journal of Gynecology & Obstetrics (IJGO), 'Institutionalization of postpartum intrauterine devices'.

Eva, G., Gold, J., Dalziel, K., (2020). ‘Economic Evaluation of the FIGO Postpartum IUD Initiative in Bangladesh and Tanzania’, Report prepared for the International Federation of Gynecology and Obstetrics (FIGO).

Eva G., Gold J., Makins, Bright, Dean, Tunnacliffe, Fatima, Yesmin, Muganyizi, Kimario, Dalziel K. (2020), “Economic evaluation of provision of PPIUD services in Bangladesh and Tanzania”. (Under Review)

Fatima, P., Antora, A.H., Dewan, F., Nash, S. and Sethi, M., (2018) “Impact of contraceptive counselling training among counsellors participating in the FIGO postpartum intrauterine device initiative in Bangladesh”. International Journal Gynecology Obstetrics, 143: 49-55.

Nahar, K., Fatima, P., Dewan, F., Yasmin, A., Laila, T., Begum, N., Deeba, F., Chowdhury, S., Akhter, N., (2018) “Acceptability and Feasibility of Postpartum Intra Uterine Contraceptive Device Insertion in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh”. Bangladesh Medical Journal, Sept; 47(3)