An Initiative Institutionalizing of Immediate Post-Partum IUD Services in Six Teaching Hospitals in Kenya
Project contact: Dr. Benjamin Elly Odongo
Background: Kenya has seen an increase of skilled delivery to 61% up from 43% (KDHS2014 /2015, 2008/2009). This has particularly been notable following the Presidential directive in 2013. However, the proportion of women leaving the health facilities without receiving a contraceptive method resulting in a missed opportunity , hampering the optimization of mother and child health care and chance for socio- economic development .
This initiative seeks to address this gap in the continuum of maternal health care.
Copper IUDs can be used by women who want to limit or space their pregnancies; can be used effectively for over 10 years and if desired can be removed easily any time after insertion. They have the lowest rates of discontinuation; are cost effective; and can be provided by mid-level providers on the long term after appropriate training. This provides a long acting reversible postpartum or post-abortion contraception and an attractive option for women.
Placement of the devise can be made during the postpartum period following normal birth within 48 hours, an elective caesarean section or following an uncomplicated abortion. It may also be placed after the peurperium as an interval method. Additional benefits women do not need to come back to the clinic for new supplies as she would with other types of contraceptives (which also suffer the disadvantages of being susceptible to stock-outs and distribution failures), has few criterion contraindications and that the device can be removed at any time with an almost immediate return of fertility.
The provision of postpartum and post abortion IUD services however requires health professionals to be trained specifically on counselling women about the overall benefits of contraception, on dispelling myths around IUDs, on safe insertion ,infection prevention and on post insertion counselling and care and observation of infection prevention practices .
Method: The initiative is descriptive in nature will involve offering of family planning counselling and provision of the chosen method, training of health personnel, strengthening of health systems, evaluation overtime (36 months) and integration beyond the funding period.
The project will involve all women attending antenatal, delivery services (SVD, Caesarean Section, immediate post-partum and post abortal) will be counselled for all FP services including PPIUD according to the National guidelines.
The project aims to institutionalize and routinely provide the practice of immediate postpartum placement of IUD as a cost – effective method in the armamentarium of family planning options.
 PPIUD services, a reference manual for providers, Jhpeigo Corporation 2010