Four years of the FIGO postpartum intrauterine device initiative in Sri Lanka: Pilot initiative to national policy.

OBJECTIVE: To analyze the difficulties and challenges arising from introduction of postpartum intrauterine device (PPIUD) services into the Sri Lankan health system.

METHODS: Phase I of a FIGO PPIUD initiative was implemented in 2013 in six hospitals; phase II began in 12 hospitals in 2015. During this period, 915 Medical Officers were trained in PPIUD insertion and 5370 personnel were trained in PPIUD counseling. Women were followed up at 4-6 weeks after insertion.

RESULTS: A total of 184 433 women (62.4% of hospital deliveries) were interviewed about PPIUD as a method of contraception. Of those interviewed, 116 159 (63.0%) received counseling on PPIUD and 11 339 (6.1%) consented to PPIUD insertion. Of consenting women, 9346 (82.4%) had a PPIUD inserted. There were no significant complications reported at insertion. Expulsion rates were 2.9% and removal rates were 4.1%.

CONCLUSION: PPIUD as a method of contraception was successfully introduced into the 18 participating hospitals. Given the success of this pilot intervention and the safety profile demonstrated, PPIUD was added to the national family planning program in 2017.