From 2013, FIGO (International Federation of Gynecology and Obstetrics) has worked through national partners in six countries to institutionalise the provision of postpartum IUD (PPIUD) services into routine maternity care. Countries were chosen based on a range of factors including high fertility rates, unmet need for contraception and maternal mortality ratios.
FIGO is now in the final phase of the project, focusing on sustainability. The project ended in India and Sri Lanka in December 2018 and is still currently running in Tanzania, Kenya, Nepal and Bangladesh.
Across 48 hospitals, the project has trained community midwives, health workers, doctors and delivery unit staff in the effort to institutionalise the practice of counselling on postpartum family planning preferably in the antenatal period, followed by skills in order that insertion of PPIUD can be inserted immediately postpartum.
TAMA and the PPIUD Project
In Tanzania, TAMA is FIGO’s official partner for the implementation of the PPIUD Project. Midwives were involved from the beginning of the project, and during its implementation, a study was conducted to explore contributions made by midwives in provision of PPIUD services in Tanzania. This study found that training midwives to provide immediate PPIUD has more potential to improve access to PPIUD services than relying on doctors. Furthermore, the complication rates when immediate PPIUD is provided by midwives are comparable to those when provided by experienced physicians. Through this study, it was discovered that 93% of PPIUD insertions following normal deliveries were done by midwives.
In Tanzania, through project advocacy, PPIUD is now included in pre-service training for healthcare providers.