A survey to assess knowledge and acceptability of intrauterine devices (IUD) among family planning clients and providers in the Family Planning services in Cape Town

Master Thesis

2007

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University of Cape Town

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[Background]The IUD is a highly effective, reliable, and safe contraceptive method that is under-utilised in many countries due to persistent fears that it causes pelvic infection. Reliable evidence of the safety of this contraceptive method has not been enough to effect a change in use. The aim of this study was to assess the knowledge and acceptability of the IUD among clients and providers in the Family Planning services in Cape Town and to attempt to identity obstacles to use. [Methods] A descriptive cross-sectional survey was conducted at eight Family Planning clinics in Cape Town. Two hundred and sixteen clients aged between 18 and 50 years, and 30 providers from the same clinics, were interviewed using structured questionnaires. [Results] Awareness of the IUD among clients was low - 81 women (41%) had heard of this contraceptive method. Ever and current use were very low. Only 9 women (4%) had ever used an IUD and 3 women were still using this method. Both the women who were interested in using this method in the future (n=77; 36%) and the women who were ambivalent or not interested in future use (n=139; 64%) cited a lack of knowledge as an obstacle to use. Although most providers were aware of the availability of the IUD (n=26; 87%). their factual knowledge was limited. Infection (n=14; 47%) and increased menstrual bleeding (n=12; 40%) were frequently mentioned as disadvantages. Referrals for and insertions of the IUD were low, and this method was often not discussed with women considering tubal ligation. Providers identified lack of client knowledge, myths and rumours among clients, lack of skilled providers to insert the device, and lack of promotion of the IUD, as significant obstacles to greater use of this method. [Conclusion] Although the IUD is available in the public sector services, it is not being utilized. Better education of both clients and providers is essential in order to improve accessibility and acceptability of this highly effective and cost effective contraceptive method.
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Includes bibliographical references (leaves 97-106).

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