A survey to assess knowledge and acceptability of the intrauterine device in the Family Planning Services in Cape Town, South Africa

Abstract

Introduction: Despite reliable evidence of the safety and effectiveness of intrauterine devices (IUDs), this contraceptive method remains under-utilised in many countries due to persistent fears that it causes pelvic infection. The aim of this study was to assess the knowledge and acceptability of IUDs among clients and providers in our family planning services and to attempt to identify barriers to use.

Methods: A descriptive cross-sectional survey was conducted at eight family planning clinics in Cape Town, South Africa. A total of 216 clients and 30 providers from the same clinics were interviewed using structured questionnaires.

Results: Awareness of the IUD among clients was low: 41% (n = 88) had heard of this contraceptive method. Ever and current use were very low. Only 4% (n = 9) had ever used an IUD, and three women were still using this method. Lack of knowledge was cited by many women as an obstacle to use. Among providers, factual knowledge about IUDs was limited, and infection (47%, n = 14) and increased menstrual bleeding (40%, n = 12) were frequently mentioned as disadvantages of the method.

Discussion and conclusions: Although the IUD is available free of charge in our public sector services, it is not being utilised. Clients lacked knowledge of this method, and research evidence had not impacted on the knowledge and practice of providers. Ongoing education of both clients and providers is essential in order to improve accessibility and acceptability of this safe and effective contraceptive method.