Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved]
Background: To accelerate progress toward Family Planning 2020 (FP2020) goals, the government of India focused on improving the quality of intrauterine device (IUD) services. EngenderHealth, an international sexual and reproductive health and rights organization, has been supporting the governments...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2020-03-01
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| Series: | Gates Open Research |
| Online Access: | https://gatesopenresearch.org/articles/3-1473/v3 |
| _version_ | 1819225393407721472 |
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| author | Manish Gehani Manoj Pal Anupama Arya Shobhana Singh Kaushik S. Kathryn A. O’Connell Levent Cagatay Sumon Sengupta Sunita Singal |
| author_facet | Manish Gehani Manoj Pal Anupama Arya Shobhana Singh Kaushik S. Kathryn A. O’Connell Levent Cagatay Sumon Sengupta Sunita Singal |
| author_sort | Manish Gehani |
| collection | DOAJ |
| description | Background: To accelerate progress toward Family Planning 2020 (FP2020) goals, the government of India focused on improving the quality of intrauterine device (IUD) services. EngenderHealth, an international sexual and reproductive health and rights organization, has been supporting the governments of Gujarat and Rajasthan since 2014 through the Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI-trained providers offer higher quality IUD services than non-EAISI-trained providers, as indicated by a reduction in confirmed IUD complications. Methods: The study team conducted an analytical cross-sectional study of secondary data collected from follow-up registers at 176 intervention facilities (38 in Gujarat and 138 in Rajasthan) during Phase I of the EAISI project. The analysis included follow-up clients who returned to the same facility between April 2018 and March 2019. We performed a multivariate logistic regression to determine factors associated with IUD complications. Results: During the period of assessment, 56,733 clients received IUD insertions, and 10,747 (18.9%) clients returned for follow-up services. Of the returning clients, 49.4% (N=5,305) had received IUDs from EAISI-trained providers, while 50.6% (N=5,442) had received IUDs from non-EAISI-trained providers. A total of 4.0% (N=432) of all returning clients experienced complications (expulsion: 1.3%, missing strings: 1.7%, infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely (95% CI [26.2%, 91.5%], p<0.0005) to have experienced complications than clients who received insertions from EAISI-trained providers. The type of IUD, the timing of the insertion, and the timing of the follow-up visit also affected complication prevalence. Conclusion: Our findings indicate that intensive, practical clinical skills training for IUD insertion can reduce the prevalence of complications. |
| first_indexed | 2024-12-23T10:08:53Z |
| format | Article |
| id | doaj.art-234940f26b214d85b1a2f528f59d49a1 |
| institution | Directory Open Access Journal |
| issn | 2572-4754 |
| language | English |
| last_indexed | 2024-12-23T10:08:53Z |
| publishDate | 2020-03-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | Gates Open Research |
| spelling | doaj.art-234940f26b214d85b1a2f528f59d49a12022-12-21T17:51:00ZengF1000 Research LtdGates Open Research2572-47542020-03-01310.12688/gatesopenres.12997.314295Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved]Manish Gehani0Manoj Pal1Anupama Arya2Shobhana Singh3Kaushik S.4Kathryn A. O’Connell5Levent Cagatay6Sumon Sengupta7Sunita Singal8EngenderHealth Inc., Ahmedabad, Gujrat, IndiaEngenderHealth Inc., New Delhi, Delhi, IndiaEngenderHealth Inc., Jaipur, Rajasthan, IndiaEngenderHealth Inc., Jaipur, Rajasthan, IndiaEngenderHealth Inc., New Delhi, Delhi, IndiaEngenderHealth Inc., Washington, DC, USAEngenderHealth Inc., Izmir, TurkeyEngenderHealth Inc., New Delhi, Delhi, IndiaEngenderHealth Inc., New Delhi, Delhi, IndiaBackground: To accelerate progress toward Family Planning 2020 (FP2020) goals, the government of India focused on improving the quality of intrauterine device (IUD) services. EngenderHealth, an international sexual and reproductive health and rights organization, has been supporting the governments of Gujarat and Rajasthan since 2014 through the Expanding Access to IUD Services in India (EAISI) project by building the capacity of service providers, monitoring compliance with standard practices, and strengthening health systems. This study sought to assess whether EAISI-trained providers offer higher quality IUD services than non-EAISI-trained providers, as indicated by a reduction in confirmed IUD complications. Methods: The study team conducted an analytical cross-sectional study of secondary data collected from follow-up registers at 176 intervention facilities (38 in Gujarat and 138 in Rajasthan) during Phase I of the EAISI project. The analysis included follow-up clients who returned to the same facility between April 2018 and March 2019. We performed a multivariate logistic regression to determine factors associated with IUD complications. Results: During the period of assessment, 56,733 clients received IUD insertions, and 10,747 (18.9%) clients returned for follow-up services. Of the returning clients, 49.4% (N=5,305) had received IUDs from EAISI-trained providers, while 50.6% (N=5,442) had received IUDs from non-EAISI-trained providers. A total of 4.0% (N=432) of all returning clients experienced complications (expulsion: 1.3%, missing strings: 1.7%, infection: 1.1%). Clients who received IUDs from non-EAISI-trained providers were 55.5% more likely (95% CI [26.2%, 91.5%], p<0.0005) to have experienced complications than clients who received insertions from EAISI-trained providers. The type of IUD, the timing of the insertion, and the timing of the follow-up visit also affected complication prevalence. Conclusion: Our findings indicate that intensive, practical clinical skills training for IUD insertion can reduce the prevalence of complications.https://gatesopenresearch.org/articles/3-1473/v3 |
| spellingShingle | Manish Gehani Manoj Pal Anupama Arya Shobhana Singh Kaushik S. Kathryn A. O’Connell Levent Cagatay Sumon Sengupta Sunita Singal Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved] Gates Open Research |
| title | Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved] |
| title_full | Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved] |
| title_fullStr | Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved] |
| title_full_unstemmed | Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved] |
| title_short | Potential for Improving Intrauterine Device (IUD) Service Delivery Quality: Results from a Secondary Data Analysis [version 3; peer review: 2 approved] |
| title_sort | potential for improving intrauterine device iud service delivery quality results from a secondary data analysis version 3 peer review 2 approved |
| url | https://gatesopenresearch.org/articles/3-1473/v3 |
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