A COMPARATIVE OBSERVATIONAL STUDY OF POSTPARTUM INTRA-UTERINE CONTRACEPTIVE DEVICE INSERTIONS IN A SUB DIVISIONAL HOSPITAL AND MEDICAL COLLEGE OF BIHAR
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 52
Abstract
BACKGROUND In order to increase the usage of birth-spacing contraceptive methods, GOI has introduced the task-sharing strategy whereby in addition to doctors, staff nurses and ANMs are also trained and entrusted with the responsibility of postpartum intrauterine contraceptive device insertion after vaginal delivery. Aims and Objectives- This study aims to compare the outcome of this strategy at a sub-divisional hospital and medical college in Bihar and to frame recommendations to increase the success of task-sharing for PPIUCD insertions by all cadres of skilled birthattendants in health-care facilities. Setting and Design- The study is conducted in two time-spans when the author was working in a sub-divisional hospital at Sherghaty and later at Sri Krishna Medical College, Muzaffarpur. It is a retrospective comparative observational analysis of data collected from the two levels of healthcare facilities. MATERIALS AND METHODS Data was collected from the PPIUCD insertion and follow-up registers maintained in both hospitals. The percentage of PPIUCD insertions after vaginal delivery and caesarean delivery, the service-provider for PPIUCD insertion, user satisfaction with the method, complications and removals were analysed. RESULTS Percentage of PPIUCD insertions was significantly higher at the SDH compared to the medical college. 50% of insertions were done by nurses and ANMs in the immediate post-placental period. User satisfaction rate was high with very low complication and low removal rates. There were no PPIUCD insertions at the medical college following vaginal delivery. No systematic follow-up records were being maintained there. CONCLUSION In order to increase the effectiveness of the PPIUCD, the task-sharing strategy of GOI can be very effective as shown by the enthusiasm and efficiency of nurses and ANMs at the SDH. Key factors to increase the usage of this PPFP method is motivation, sensitive counseling skills and adequate training and confidence in its insertion technique.
Authors and Affiliations
Tripti Sinha
Keywords
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- EP ID EP550486
- DOI 10.14260/jemds/2018/1216
- Views 84
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