Intrauterine Contraceptive Device insertion service specific readiness at Primary Health Care level using DLHS- 4 data: A country- wide study

Background: As per census 2011, India’s population is touching 1.21 billion with Total Fertility Rate(TFR) of 1.8 for urban and 2.4 for rural area, India still strives for demographic transition from late expandingstage to low stationary. IUCD, one of the effective methods of contraception uptake is dismally low as suggested by NFHS-4 data. Objective: The present study was planned to document the quality- basedassessment of IUCD insertion facility and availability of trained service providers across the country using District Level Health Survey IV (DLHS- IV) data. Material and Methods: The DLHS-4 facility level datawas used for the analysis. The outcome measures assessed was status of training, availability of autoclave,IUCD insertion kit, instrument trolley, SIMS speculum, examination table, privacy, and status of recordmaintenance. The proportions and 95% confidence intervals (CI), were presented wherever appropriate. Result: At sub centre, IUCD insertion kit and other equipment were present in nearly three-fourth offacilities, with lack of basic facilities in most of the subcentres. The PHC situation was relatively better interms of basic facilities. Only two-thirds of ANMs and half of Medical officers were trained for IUCD insertion. Conclusion: The lack of infrastructure and inadequate training of health staffs deters the potentialIUCD acceptors from availing the services. To increase the uptake, the necessary steps for provision ofinfrastructure and training of health staffs has to be taken on priority basis.