RT Journal Article
SR Electronic
T1 Increasing postpartum IUCD coverage through a QI initiative: a step towards reducing the unmet need of postpartum contraception
JF BMJ Open Quality
JO BMJ Open Qual
FD British Medical Journal Publishing Group
SP e001346
DO 10.1136/bmjoq-2021-001346
VO 10
IS Suppl 1
A1 Swati Agrawal
A1 Manju Puri
A1 Anuradha Singh
A1 Sushma Sehrawat
A1 Shilpa Sood
A1 Kavita Choudhary
A1 Anu Handa
A1 R Induja
A1 Apurwa Bardhan
A1 Pooja Luthra
A1 Preeti Pawar
A1 Nidhi Singh
A1 Swati Tyagi
A1 Jismaria Antony
A1 Priyanka Arora
A1 Sukriti Ghai
A1 Tanya Shubham
A1 Vaishali Suraiya
A1 Surabhi Sapna
A1 Mani Ajithkumar
YR 2021
UL http://bmjopenquality.bmj.com/content/10/Suppl_1/e001346.abstract
AB Background Unintended pregnancies have a negative impact on the health and economy of a nation, which can be prevented by effective family planning (FP) services. Postpartum intrauterine device (PPIUCD) is a safe and effective FP method which allows women to obtain long-acting contraception before discharge from the point of delivery. We observed poor coverage of deliveries with PPIUCD at our facility. This was the trigger to initiate a quality improvement (QI) initiative to increase the PPIUCD coverage from current rate of 4.5%–10% in 3-month period.Method A fishbone analysis of the problem was done and the following causes were identified: lack of focused counselling for FP, lack of sensitisation and training of resident doctors and inconsistent supply of intrauterine contraceptive devices (IUCDs). A QI team was constituted with representatives from faculty members, residents, interns, nursing officers and FP counsellors. The point of care quality improvement methodology was used.Interventions Daily counselling of antenatal women was started by the counsellors and interns in antenatal wards. A WhatsApp group of residents was made initially to sensitise them; and later for parking of problems and trouble shooting. The residents were provided hands-on training at skills lab. Uninterrupted supply of IUCDs was ensured by provision of buffer stock of IUCDs with respective store keepers.Result The PPIUCD insertion rates improved from 4.5% to 19.2% at 3 months and have been sustained to a current 30%–35% after 1 ½ years of initiation of the project tiding through the turbulence during the COVID-19 pandemic using QI techniques.Conclusion Sensitisation and training of residents as well as creation of awareness among antenatal women through targeted counselling helped improve PPIUCD coverage at the facility. QI initiatives have the potential to facilitate effective implementation of the FP programmes by strategic utilisation of the resources.All data relevant to the study are included in the article.