The intrauterine device (IUD) is an effective and long-acting family planning method, with a failure rate of less than 1 percent over the first year of use. In addition, an IUD is convenient, easy to use—it does not require the user to do anything once it is inserted—has few side effects and fertility returns promptly after it is removed.
One problem encountered in the early years of IUD usage was the introduction of infection by providers who contaminated the device while inserting it. To address this issue, Jhpiego helped pioneer the “no-touch” technique, which allows the provider to manipulate the device inside its sterile package and to insert the IUD without touching the device itself and without the device touching the walls of the woman’s vaginal canal. This technique greatly reduces the risk of infection and removes the need for sterile gloves, which often is a barrier in providing IUD services.
Using this device, Jhpiego was one of the first organizations to demonstrate that trained mid-level providers such as nurses and midwives could perform IUD insertion safely and effectively. Jhpiego found that competency-based training with simulated practice in IUD insertion on anatomic models reduced the risk of harming clients and reduced trainees’ performance anxiety, which often hinders learning.
In 1992, Jhpiego published its first IUD reference manual, IUD Guidelines for Family Planning Service Programs: A Problem Solving Reference Manual, which was translated into French. This material and the competency-based training tools made a standardized, safe and efficient approach to training and service provision, using the “no-touch technique,” possible. The second edition of the manual was translated into Spanish, Portuguese and Russian, and many countries adapted these materials to meet their needs. Jhpiego also incorporated the manual into ModCAL®, its Modified Computer-Assisted Learning approach, which allowed trainees to learn about IUD counseling, insertion and removal at their own pace. In response to a resurgence of interest in the IUD, in 2006, Jhpiego revised and updated the reference manual and associated materials to provide the latest essential information to clinicians, clinic managers and clinical trainers to improve the quality of IUD services.
More recently, to meet the demand for postpartum family planning services, in 2010 Jhpiego published Postpartum Intrauterine Contraceptive Device Services: A Reference Manual for Providers. This document, which is available in English and Spanish, is part of a learning resource package to prepare a range of qualified service providers to deliver high-quality IUD services as part of a comprehensive postpartum family planning program.