Expanding Contraceptive Method Choice With a Hormonal Intrauterine System: Results From Mixed Methods Studies in Kenya and Zambia.

Introduction: Few women in low- and middle-income countries have access to the hormonal intrauterine system (IUS). Past research from a small number of facilities and the private sector suggest the IUS could be an important addition to the contraceptive method mix because it is the only long-acting method some women will adopt and users report high satisfaction and continuation. We aimed to determine whether these promising results were applicable in public facilities in Kenya and Zambia.

Feasibility of training Zambian nurse-midwives to perform postplacental and postpartum insertions of intrauterine devices.

Objective: To explore the feasibility of competency-based training of Zambian nurse-midwives in postplacental and postpartum intrauterine device (PPIUD) insertion and to estimate learning curves for this procedure.

Methods: A pilot service-delivery project was conducted, involving 9 nurse-midwives who participated in a 10-day PPIUD insertion training course at the University Teaching Hospital, Lusaka, Zambia. US and Zambian clinicians taught the didactic and practical curriculum.

Dedicated providers of long-acting reversible contraception: new approach in Zambia.

Background: Long-acting reversible contraception (LARC) is underused in many countries in sub-Saharan Africa. Many previous attempts to increase uptake of this important class of contraception have not been successful.

Study Design: This program in Zambia employed 18 dedicated providers of LARC, placed them in high volume public sector facilities and collected routine, anonymous information over a 14-month period.