The PPIUD Study

I am a part of the team at Harvard that was charged with the task of evaluating the effects of a postpartum IUD (PPIUD) intervention in Nepal, Sri Lanka, and Tanzania.  A description of the intervention can be found here, and a description of the stepped-wedge cluster randomized evaluation protocol can be found here.  

As the focal point for the Tanzania, I worked closely with colleagues from the  Association of Gynaecologists and Obstetricians of Tanzania (AGOTA)  and Management and Devleopment for Health (MDH) to help design and implement data collection activities at five referal hospitals throughout the country.  

Several pieces have been published from this study.  Our published qualitative work assesses women's perspectives on the IUD, and evaluates client and provider perspectives of the intervention.  Our primary quantative analysis explored PPIUD counseling rates and method uptake.

The data analyses I'm focusing on currently, however, take a more expansive view of our evaluation task.  Rather than focusing exclusively on outcomes related to the PPIUD, I am examining a broader set of outcomes focused on contraceptive method mix and quality of care.  Preliminary findings from both the qualitative and quantitative analyses indicate that the PPIUD intervention in Tanzania led to a sort of tunnel-vision on IUD uptake that ended up reducing access to other methods, lowering patient satisfaction, and negatively impacting quality of care.

These preliminary findings were presented at the 8th African Population Conference in Entebbe, Uganda.