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When the PPIUD Initiative was first conceptualised in 2013, the focus was on reducing maternal mortality, in accordance with Millenium Development Goal 5 (MDG 5). It was well established that a 30% reduction in maternal mortality can be achieved by offering contraception to women in the reproductive age group. We knew that nearly 2.2 million women did not have access to contraception, even if they wanted it, and we wanted to reduce the number of abortions for unintended pregnancies.
We recognised that in low- and middle-income countries (LMICs) there was little else offered to women postpartum other than permanent sterilisation. We wanted to support the societies in introducing long acting reversible contraceptives (LARCS) for mothers, so that they could have another child if and when then they wish, with spaced births. As well as reducing maternal mortality, birth spacing also reduces the likelihood of miscarriage, preterm births, intrauterine growth restriction and under-5
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Following five years of implementation since January 2015, FIGO’s Postpartum Intrauterine Device (PPIUD) Initiative is now wrapping up project activities and fully handing over responsibility for postpartum family planning (PPFP) services in the country to our partner, the Obstetrical and Gynecological Society of Bangladesh (OGSB). The project ran in six centres, with three outside of the capital and three within Dhaka.
PPIUD is an invaluable option for women postpartum in low-resource settings as it can be inserted immediately after delivery of the baby, meaning that women do not need to make regular and often long journeys back to health facilities to receive contraception.
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“Choosing a method for myself, I needed a long-acting reversible method because I want to have another child in 5 or 6 years, I did not hesitate to choose PPIUD. It is also non-hormonal so I am able to breastfeed my baby, which is important to me.”
Najbin Akter, PPFP Counsellor at Khulna Medical College Hospital and PPIUD user
To this end, in 2013 FIGO began the ‘Institutionalisation of Immediate Postpartum IUD (PPIUD) Services Initiative.’ It has trained community midwives, health workers, doctors and delivery unit staff in counselling on postpartum family planning (PPFP) and insertion of IUDs immediately postpartum.
We are proud to celebrate the impressive achievements of each of the countries involved in this project. For this article, we look at the success of the project in Bangladesh.