IUDs, despite being safe, effective and relatively inexpensive, aren't widely embraced by women in the developing world. There are likely several reasons why, including, as Stanford's Paul Blumenthal, MD, tells me, "myths and rumors about the IUD, uncertainty or inadequate information about where a woman could get one, and an inadequate number of providers trained and ready to provide a quality service."
Many women face challenges in obtaining other forms of birth control, as well, and a group of researchers recently launched a two-year initiative to increase women’s contraceptive options and improve reproductive health in 13 developing countries.
[Our] experience with promoting a contraceptive previously believed to be unsuitable... should encourage both public and private providers
The initiative focused on both creating demand and improving service delivery. A group of community “mobilizers” conducted outreach in many of the countries, going door to door or gathering in group settings to educate women on family planning options and linking them with local providers. Media activities, including radio and TV spots, printed educational materials and billboards, were also done in many areas to address misconceptions about reversible contraceptives and to educate women on the potential benefits of using them.
Project leaders also improved access by training local clinic staff on counseling, complication management, side effects, removals and referrals, and by offering IUD insertion at a variety of clinics throughout each of the countries. Outreach clinic event days were held in six countries, during which IUD insertions were offered to local women over a one- to three-day period.
Between January 2009 and December 2010, 575,601 women across the 13 countries were provided with IUDs. The typical woman who received an IUD was in her 20s, married, had at least one living child and was primary-school educated. Twenty-four percent of women who received an IUD said they previously had been using no modern birth control method.
Blumenthal, who worked with PSI on the project and is lead author of a study appearing in Contraception, told me that a “success at this scale has not been previously reported.” And the researchers, who are continuing their project and expanding to other countries, wrote in the paper that their "experience with promoting a contraceptive previously believed to be unsuitable for these contexts should encourage both public and private providers."
Previously: Using family planning counseling to reduce number of HIV-positive children in Africa, Access to contraceptives best way to cut maternal and newborn deaths in developing world, advocates argue and Africa and the pill