Clinical training alone is not sufficient for reducing barriers to IUD provision among private providers in Pakistan

Agha, Sohail; Fareed, Aslam; Keating, Joseph

doi:10.1186/1742-4755-8-40

Reproductive Health

Table 2 Differences in knowledge and attitudes towards IUD provision among physicians versus LHVs, providers trained in last three years versus not, network members versus not, experienced providers (> 45 insertions) versus not

From: Clinical training alone is not sufficient for reducing barriers to IUD provision among private providers in Pakistan

	Physician			Trained in clinical FP in last 3 years			Network member			Experienced provider
	Yes n = 284	No n = 282	Adjusted¹ Odds Ratio	Yes n = 354	No n = 212	Adjusted Odds Ratio	Yes n = 415	No n = 151	Adjusted Odds Ratio	Yes n = 463	No n = 103	Adjusted Odds Ratio
Knowledge of Multiload	%	%		%	%		%	%		%	%
Knows effectiveness	76.8	79.0		79.6	75.0		78.1	76.8		81.6	63.2	2.53***
Knows duration of effectiveness	76.1	74.0		77.9	70.4		75.9	72.8		76.5	69.6
Has sufficient information to advise	93.9	96.0		98.3	89.6	3.42*	97.6	88.1	3.84**	98.2	82.6	8.26***
Considers herself expert at insertion	80.6	83.9		86.7	74.6		83.1	80.1		91.6	45.2	12.43***
Appropriate candidates for IUD
If no contraindications, would recommend IUD to following women
Nulliparous	11.2	20.6	0.48**	16.9	13.7		17.6	10.6	1.89*	16.2	13.9
With one delivery	83.0	87.1		88.1	80.2	1.65*	86.5	80.8		85.6	83.5
With 3+ deliveries	97.6	97.4		98.9	95.3		98.8	94.0	3.41*	98.7	93.0	4.63**
Age 19 or younger	34.1	50.2	0.48***	39.8	45.3	0.66*	42.7	39.7		42.0	40.9
Age 20-24	90.4	93.4		93.8	88.7		92.5	90.1		93.8	84.2	2.48**
Age 25-29	97.3	94.9		98.3	92.0	4.51**	97.3	92.7		97.1	92.2
Age 30-34	94.6	90.8		93.2	92.5		93.2	92.1		94.5	87.0	2.67**
Age 35-39	76.5	74.6		77.6	72.2		77.5	70.2		78.7	63.5	2.05**
Age 40 or older	46.3	43.4		44.9	44.6		43.9	47.7		50.6	22.6	3.80***
Wants children in future	85.7	87.2		87.3	85.0		87.0	85.4		87.6	82.5
Had spontaneous abortion	31.7	37.9		35.7	32.9		34.2	35.8		35.7	30.4
Had ectopic pregnancy	23.2	29.7	0.66*	22.9	31.9	0.55**	26.3	26.5		27.3	22.6
The following concerns would negatively influence recommendation of the IUD
Medical safety	79.6	63.6	2.30***	71.8	72.2		72.8	69.5		73.0	67.8
Side-effects	71.4	64.3		69.8	65.1		68.9	65.6		68.4	66.7
Client satisfaction	44.2	45.4		45.3	43.9		45.3	43.0		43.7	48.7
Informed consent is cumbersome	20.8	17.6		22.9	13.2	2.47***	19.0	19.9		17.1	28.1	0.43**
Expense	4.4	3.3		4.0	3.8		3.9	4.0		2.7	8.8	0.25**

*p < 0.05 **p < 0.01 ***p < 0.001 ¹Adjusted for other three independent variables in Table 2 (e.g. training in clinical FP provision, membership of network and experience in IUD provision)

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ISSN: 1742-4755

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