Quality postpartum IUD (PPIUD) service provision requires providers who are knowledgeable and competent not only in PPIUD insertion, but also postpartum family planning (PPFP) counseling. Training should cover both counseling skills and practice on anatomic models to develop competency with standard steps before providing PPIUDs to postpartum women under trainers’ supervision. One of the most important steps in training is follow-up post-training to support the newly-trained providers shortly after training and on an ongoing basis. India has an example of follow-up guidelines.

Sensitization and counseling among antenatal clients are essential to generate demand for the service and should begin well in advance of the training. This should be supplemented with counseling among women in the labor ward (who are not in active labor) as soon as trained providers are available to offer the service. It is important to ensure that the client load is sufficient for trainees to build competence in IUD insertion. One program that trained midwives found that 4 supervised IUD insertions were required on average to reach competency. 

Available training materials for PPIUD services are:

• Access-FP's Postpartum IUD Learning Resource Package (Updated by MCHIP in 2013), which includes key guidance on PPFP and PPIUD. Specifically, this package includes training on counseling, initiating PPIUD services, following up with clients, and management of potential problems. This 4 or 5 day competancy-based training is detailed in the reference manual and trainer's guide, which contain exercises, checklists, assessment tools, and guidance on metnoring in the clinical setting. The package also includes a learner's guide that provides the learner with materials for active participation in the training.
• An animated training video that shows the entire PPIUD insertion procedure, including how to place the IUD high in the fundus.
• ACQUIRE's Postpartum Intrauterine Device Training Package (2008), which includes a trainer's manual and a participant's handbook, which are divided into 10 modules, with appendices. The trainer's manual features learning objectives and instructions for conducting each session as well as learning tools and other resources trainers can use to support the sessions. The participant's handbook contains the technical content; therefore, trainers need a copy of each book to conduct the training successfully.

In addition to these training materials, this section of the Toolkit includes counseling tools and information, training guidance, and checklists. To see lessons learned from a variety of country programs, please visit the Country Experiences section of the toolkit.

Do you have PPIUD experience that is not represented in this toolkit? To suggest an additional resource or share your perspective, please email us at toolkits@k4health.org or visit our feedback form.