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The intrauterine device (IUD) is a safe, effective, and reversible contraceptive method, however in many countries use of the IUD is stagnant or declining in relation to other contraceptive methods. In 2002, the Population Council investigated the reasons for low utilization of IUDs among women in Ghana and Guatemala. The studies examined clients’ and providers’ knowledge and attitudes about IUDs as well as factors within the health system that affect their use and availability. The studies took place at public, private, and nongovernmental health centers and clinics in both rural and urban settings. Researchers collected qualitative data using a combination of focus group discussions, in-depth interviews with providers, and visits from simulated clients enacting profiles of women wishing to space or limit pregnancies. The studies also included a secondary analysis of service statistics from government and private clinics. As concluded in this brief, lack of knowledge among providers and clients, logistical problems, and cumbersome guidelines contributed to low use of the IUD in Ghana and Guatemala. Efforts to improve use should include more comprehensive training for providers, education for clients, and logistical support.






Frontiers in Reproductive Health