Norplant® implant use-dynamics diagnostic study: indonesia 1991

Area of Science:

• Reproductive Health
• Family Planning Programs
• Medical Device Implementation

Background:

• Indonesia's national family planning program is the world's largest introduction of the NORPLANT® implant.
• The program reached a critical stage with the first five-year removals due in late 1991.
• The ANEORTA Project aimed to study NORPLANT® implant use dynamics.

Purpose of the Study:

• To conduct a diagnostic study of NORPLANT® implant program functioning in two Indonesian provinces.
• To assess the feasibility of locating acceptors and their continued implant use.
• To gather early information on program operations before a larger Use-Dynamics Study.

Main Methods:

• A diagnostic study was conducted in six clinics per province (West Sumatra and West Java).
• Interviews were held with service providers, and clinic records were examined.
• 120 NORPLANT® implant acceptors were visited to assess location and continued use.

Main Results:

• Approximately 70% of acceptors received NORPLANT® implants from non-clinical sources (safaris/mobile teams).
• The four-year life-table continuation rate was 78%.
• No specific written information on NORPLANT® was available for providers or clients, though records generally aligned with official data with some gaps.

Conclusions:

• Clinical staff, records, and logistics appeared generally adequate for five-year NORPLANT® implant removals, contrary to some expectations.
• Training in insertion and removal was common among physicians, nurse-midwives, and nurses.
• Addressing information gaps for providers and clients is recommended for program improvement.