Addressing the Challenges of Clinician Training for Long-Acting Reversible Contraception

Potter, Julia M.; Koyama, Atsuko; Coles, Mandy S.

doi:10.1001/jamapediatrics.2014.2812

Cited by 18 publications

(14 citation statements)

References 6 publications

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“…However, there is probably a large untapped potential to improve provider attitudes towards IUDs by ensuring that all professionals involved in family planning receive regular technical updates and in-service training [ 106 , 107 ]. In high-income countries, OB/GYNs are more likely than general practitioners and nurses to receive regular updates on contraceptive safety, which may explain the different levels of knowledge between these professional categories.…”

Section: Discussionmentioning

confidence: 99%

Provider and lay perspectives on intra-uterine contraception: a global review

et al. 2017

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BackgroundIntra-uterine contraception (IUC) involves the use of an intra-uterine device (IUD), a highly effective, long-acting, reversible contraceptive method. Historically, the popularity of IUC has waxed and waned across different world regions, due to policy choices and shifts in public opinion. However, despite its advantages and cost-effectiveness for programmes, IUC’s contribution to contraceptive prevalence is currently negligible in many countries.This paper presents the results of a systematic review of the global literature on provider and lay perspectives on IUC. It aims to shed light on the reasons for low use of IUC and reflect on potential opportunities for the method’s promotion.MethodsA systematic search of the literature was conducted in four peer-reviewed journals and four electronic databases (MEDLINE, EMBASE, POPLINE, and Global Health). Screening resulted in the inclusion of 68 relevant publications.ResultsMost included studies were conducted in areas where IUD use is moderate or low. Findings are similar across these areas. Many providers have low or uneven levels of knowledge on IUC and limited training. Many wrongly believe that IUC entails serious side effects such as pelvic inflammatory disease (PID), and are reluctant to provide it to entire eligible categories, such as HIV-positive women. There is particular resistance to providing IUC to teenagers and nulliparae. Provider opinions may be more favourable towards the hormonal IUD. Some health-care providers choose IUC for themselves.Many members of the public have low knowledge and unfounded misconceptions about IUC, such as the fear of infertility. Some are concerned about the insertion and removal processes, and about its effect on menses. However, users of IUC are generally satisfied and report a number of benefits. Peers and providers exert a strong influence on women’s attitudes.ConclusionBoth providers and lay people have inaccurate knowledge and misconceptions about IUC, which contribute to explaining its low use. However, many reported concerns and fears could be alleviated through correct information. Concerted efforts to train providers, combined with demand creation initiatives, could therefore boost the method’s popularity. Further research is needed on provider and lay perspectives on IUDs in low- and middle-income countries.Electronic supplementary materialThe online version of this article (10.1186/s12978-017-0380-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Provider and lay perspectives on intra-uterine contraception: a global review

et al. 2017

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“…18 Thus, the lack of information received by women from family planning professionals reflects the lack of knowledge among these professionals about the safety of IUDs as a contraceptive method for nulliparous women. [19][20][21][22] A study that evaluated the attitude, knowledge, and practice on IUD use showed that less than half (46%) of reproductive health physicians considered this contraceptive method to be indicated for nulliparous women. 19 For a long time, nulliparous women and adolescents constituted a group of patients for whom IUDs were contraindicated 23 and, although the American College of Obstetricians and Gynecologists, in 2012, recommend that IUDs should be considered the first choice of contraceptive for adolescents, 10,11 its prescription is still low.…”

Section: Discussionmentioning

confidence: 99%

Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices

Scavuzzi

Souza

Amorim

2016

Rev Bras Ginecol Obstet

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“…Ongoing efforts to encourage LARC such as implant or IUD use among adolescents are important to enhance uptake of these highly effective methods. 35 However, current data indicate that less than 5% of young women across the United States choose a LARC method. [36][37][38] There are many obstacles to placement of LARC methods, including financial or insurance barriers, knowledge gaps in safety and efficacy, and parental support.…”

Section: Discussionmentioning

confidence: 98%