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Updated: Sep 2, 2025

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Barriers and Facilitators to Implementing Immediate Postpartum Contraceptive Implant Programs: A Formative

Jen Sothornwit1, Pisake Lumbiganon1, Kesinee Saranrittichai2

  • 1Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

International Journal of Women'S Health
|August 4, 2022
PubMed
Summary

Implementing immediate postpartum (IPP) contraceptive implants requires addressing barriers like insufficient training and client knowledge gaps. Strengthening facilitators such as reimbursement policies and client education is key for successful, sustainable programs.

Keywords:
contraceptive implantsimplementation scienceinfluencing factorslong-acting reversible contraceptionpostpartum contraception

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Area of Science:

  • Reproductive Health
  • Implementation Science
  • Public Health Policy

Background:

  • Immediate postpartum (IPP) insertion of contraceptive implants is a critical service for preventing unintended pregnancies.
  • Understanding implementation factors is essential for service expansion and sustainability.

Purpose of the Study:

  • To identify barriers and facilitators to developing and implementing IPP contraceptive implant services.
  • To apply the Consolidated Framework for Implementation Research (CFIR) to analyze these factors in Thailand.

Main Methods:

  • Conducted in-depth interviews and focus group discussions.
  • Utilized the CFIR framework for data collection and analysis across community, regional, and university hospitals.

Main Results:

  • All CFIR domains impacted planning and implementation.
  • Identified nine constructs as barriers or facilitators, and four as both.
  • Key barriers included insufficient training budget, lack of supportive policies, and low client knowledge; facilitators included relative advantage of implants, reimbursement, supportive laws, KPIs, champions, and client education.

Conclusions:

  • Successful IPP contraceptive implant programs require overcoming modifiable barriers and strengthening facilitators.
  • Tailored strategies and robust client education (hospital and community) are crucial for program sustainability.