Norplant® implant use-dynamics diagnostic study: indonesia 1991

Indonesia's national family planning program constitutes the largest introduction of the NORPLANT® implant in the world. With the first five-year removals occurring in late 1991, the program was at a critical stage. In Fall 1991, the ANEORTA Project conducted a Use-Dynamics Study to look systematically at NORPLANT® implant use in the field. To prepare for that study, and to get early information on program functioning, BKKBN and the Population Council, in conjunction with Andalas University in West Sumatra and BKS-PENFIN in West Java, undertook a diagnostic study of six clinics in each of two provinces, interviewing service providers and examining records. A total of 120 acceptors were visited to determine the feasibility of locating them and whether they were still using implants. About 70 percent of the acceptors had accepted from non-clinical sources, either "safaris" or mobile team visits. The four-year life-table continuation rate was 78 percent. No written information specifically devoted to the NORPLANT® implant was available either to providers or to clients. Available records generally matched official records, although significant gaps were found. All physicians and nurse-midwives, as well as many nurses, had some training, formal or informal in NORPLANT® implant insertion and removal. Contrary to expectation, clinical staff, records, and logistics all seemed generally adequate for five-year removal, although some problems were anticipated.