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IUD Toolkit

Up-to-date evidence and best practices related to the Intrauterine Device

Brought to you by USAID's Maximizing Access & Quality Initiative

Training of IUD Providers

Providers play a pivotal role in the IUD's availability and use. Providers not only conduct IUD counseling, insertion, and removal, they serve as "gatekeepers" whose attitudes and actions influence whether and how clients use IUDs. It is thus important to take a "provider perspective," and to address the knowledge, skills, motivations, and needs of providers (see training section for details).
Rather than trying to train and support a large number of IUD providers, who often will have relatively few clients each and thus difficulty in maintaining skills, it may make more sense to identify currently or potentially active IUD providers and to support them in a more sustained fashion. Such providers tend to build up a satisfied clientele who attract other potential users. These providers can also serve as trainers, mentors, and role models ("champions") for other providers. Similarly, training and program efforts can be focused on fewer, higher-quality, sites-"centers of excellence"-for training and service delivery, with an aim to subsequently expand and scale up once quality IUD services are flourishing.
With a competency-based training approach that first uses pelvic models during training before then proceeding to actual insertion, most paramedical providers achieve competency to provide clinical IUD services with as few as three insertions in clients (Ajello et al., 1994); (Montufar et al., 2005); (Villanueva et al., 2001). Paramedical providers can be trained at their own service sites, and many will continue using their skill after training is completed (Montufar et al., 2005).
A significant proportion of trainees who begin IUD training may not complete the training because of a lack of adequate numbers of IUD clients for training. Of those trainees who do complete their training, many do not subsequently provide IUD services due to lack of confidence in their newly acquired skills, inability to identify women interested in the method, and/or lack of appropriate on-site supervision and follow-up (Katz et al., 2002); (Villanueva et al., 2001).