Impact and Performance of Institutionalizing Immediate Post-partum IUD Services
- Conditions
- Contraception
- Interventions
- Device: Post-partum IUD
- Registration Number
- NCT02718222
- Lead Sponsor
- Harvard School of Public Health (HSPH)
- Brief Summary
Studying the impact and performance of institutionalizing immediate post-partum IUD services as a routine part of antenatal counselling and delivery room services in Sri Lanka, Tanzania, and Nepal.
- Detailed Description
The International Federation of Gynaecology and Obstetrics (FIGO) has designed and is planning to implement, through its nationally-affiliated Associations of Gynaecologists and Obstetricians, an intervention program on post-partum IUD (PPIUD) services. As part of this Program, FIGO is responsible for information material, training providers, improving facilities, quality of service, and monitoring the program. Independent of the implementation, this study will measure the impact and performance of this intervention in three (Sri Lanka, Nepal and Tanzania) of the six countries participating in the FIGO project entitled: "Institutionalization of immediate post-partum IUD (PPIUD) services as a routine part of antenatal counselling and delivery room services in Sri Lanka, Kenya, India, Tanzania, Nepal and Bangladesh." The FIGO intervention will take place over a nine-month period in Tanzania (nine months in the first group of three hospitals and three months in the second group of three hospitals), and over a fifteen-month period in Nepal and Sri Lanka (fifteen months in the first group of three hospitals and nine months in the second group of three hospitals). Investigators will study both the impact of the intervention on the uptake and subsequent continued use of PPIUD and the extent to which the intervention leads to the institutionalization of postpartum IUD services in the hospitals during and after the FIGO intervention and to what extent the service diffuses to other hospitals or providers. The institutionalization and diffusion of the intervention will be measured by interviewing and following up trained providers, review of hospital records and baseline, during intervention and post-intervention facility surveys.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 140258
- Delivered in intervention hospital during 12-month enrollment period (Tanzania)/18-month enrollment period (Nepal and Sri Lanka)
- Does not live in the country where delivered
- Tanzania only: Under age 18
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description 9-15 months PPIUD intervention Post-partum IUD Tanzania: Baseline (no intervention) period is 3 months. Post-partum IUD intervention begins after 3 months and continues for 9 months. Nepal and Sri Lanka: Baseline (no intervention) period is 3 months. Post-partum IUD intervention begins after 3 months and continues for 15 months. 3-9 months PPIUD intervention Post-partum IUD Tanzania: Baseline (no intervention) period is 9 months. Post-partum IUD intervention begins after 9 months and continues for 3 months. Nepal and Sri Lanka: Baseline (no intervention) period is 9 months. Post-partum IUD intervention begins after 9 months and continues for 9 months.
- Primary Outcome Measures
Name Time Method Percentage uptake of PPIUD Within approximately 24 hours postpartum, before discharge from the hospital. To ascertain what percentage of women delivering in study hospitals take uptake PPIUD, participants will be interviewed after delivery, before they are discharged from the hospital.
- Secondary Outcome Measures
Name Time Method Percentage of women receiving PPIUD counseling Within approximately 24 hours postpartum, before discharge from the hospital. To ascertain what percentage of women delivering in study hospitals receive counseling on PPIUD, participants will be interviewed after delivery, before they are discharged from the hospital.
Percentage of women pregnant at 18 months postpartum 18 months postpartum Participants will be interviewed at 18 months and asked whether they are pregnant.
Percentage of PPIUD acceptors who have expulsions at 4-6 weeks postpartum 6 weeks postpartum Participants who have not deliberately removed the PPIUD will be examined by providers at 4-6 weeks postpartum, and providers will report whether the PPIUD was expelled.
Percentage of women using modern contraception at 9 months postpartum 9 months postpartum Participants will be interviewed at 9 months and asked whether they are using a modern method of contraception.
Percentage of women using modern contraception at 18 months postpartum 18 months postpartum Participants will be interviewed at 18 months and asked whether they are using a modern method of contraception.
Trial Locations
- Locations (3)
Center for Research on Enviornment Health and Population Activities
🇳🇵Kathmandu, Nepal
Sri Lanka College of Obstetricians and Gynecologists
🇱🇰Colombo, Sri Lanka
Management and Development for Health
🇹🇿Dar es Salaam, Tanzania