*Barriers and Challenges in the Acceptance and Continuation of Postpartum Intrauterine… DOI: http://dx.doi.org/10.5772/intechopen.112366*

with burgeoning population. However, during the last two decades, there has a resurgence of interest globally in the use of the IUCD during the immediate postpartum period within forty-eight hours of delivery when the woman is still within the delivery site. FIGO's initiative in popularizing it in six LMICs as a viable PPFP option in the contraceptive basket has been strengthened by nongovernmental organizations, such as JHpiego, USAID, PSI, and MCHIP. They are collectively extending technical and training support to various governments in southeast Asia and sub-Saharan Africa who have recognized the immense potential in promoting their respective national population control policies and programs.

As for any program launched on a widespread scale, PPIUCD FP program also requires robust field data pertaining to the users, as well as service providers, administrative, and budgetary cells in order to evaluate, whether it is performing satisfactorily as regards its expected primary and secondary related outcomes. Accumulated data from systematic reviews on the topic indicate that the main barriers and challenges in increasing acceptance and continuation of PPIUCD are low awareness, and hence demand for its use by prospective clients. This is coupled with low motivation, poor counseling and technical skills, and confidence of service providers in its insertion. Other issues of concern relate to supply chain, which has to be addressed by policy makers and health and FP budget planners.

From whatever data that have accumulated from diverse LMIC populations PPIUCD despite its "below expected" success in lowering TFR remains a promising PPFP option for eligible women provided it is backed up by proper IEC strategies coupled with training in quality counseling and insertion skills and practice by the service providers. Individual prejudices based on limited personal experience and opinion need to be aggressively curtailed in order to prevent reduction in rates of user acceptance of a very useful contraceptive method. Future research in the individual country specific contexts should be directed at obviating such obstacles for the wider use of this effective PPFP method, which has the benefit of being an extremely effective LARC, which compares favorably with permanent birth limiting methods.
