Facilitators and barriers in acceptance of postpartum intrauterine contraceptive devices in Bihar

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Original Article

Author :

Bhanu Shanker Singh*, Dhananjay Srivastava, Jaswinder Kaur

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Abstract :

Background: In India, Postpartum IUCD services were introduced in 2010, which is being scaled up, in a phased manner. Insertion of PPIUCD during the immediate postpartum period provides increased motivation and focuses on the prevention of unintended pregnancies along with spacing. Spacing more than 2 years reduces one-third of maternal mortality and 10% of child mortality. This study is an attempt to understand facilitating factors and barriers to using PPIUCD in Bihar. Materials and Methods: A cross-sectional study using a mix-method approach was conducted in nine divisional headquarters districts of Bihar – in various level health facilities. A total of 1620 women, 18-49 years who had institutional delivery and 344 Healthcare providers were covered. Results: Facilitating factors were awareness (53.2%), incentivization (50.5%), better quality of device/services along with incentivization, and proper training to ASHA/ANM (2.6%). The discontinuation rate of PPIUCD was 25.9% and the major reasons for discontinuation were health problems/side effects, husband/family member’s disapproval, and preference for another method. Major barriers for non-acceptance were the preference for another method, Husband/Family member’s disapproval, Health problems/side effects, and Lack of awareness. Conclusion: Comprehensive counseling during ANC, Delivery and of husband/family members, publicity through mass media, educational campaigns, timely incentivization, regular follow-up check-ups, Promoting of PPIUCD by the healthcare providers are some of the ways to address the barriers and thereby facilitate the use of PPIUCD.  

Keyword :

Barriers, Contraception, Facilitating factors, Postpartum IUCD, PPIUCD.
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