The intrauterine device (IUD) is a safe and effective method of reversible contraception. IUDs are small flexible devices made of metal, copper and/or plastic that prevent pregnancy by a combination of action mechanisms: a) inhibition of sperm migration in the upper female genital tract; b) inhibition of ovum transport; and c) inhibition of fertilization.

The IUD is typically recommended to women of reproductive age who:

• require a highly effective reversible method of contraception
• prefer a method that does not require a daily routine, or a separate action with every act of sexual intercourse
• are breast-feeding
• may have difficulty obtaining contraceptives on a regular basis
• feel that lack of privacy makes use of other methods problematic
• for medical reasons do not want to use hormonal contraceptives.

PSI's Green Star Network in Pakistan has designed a system that effectively responds to the requirements set forth for IUD insertion and use. PSI's first partnership with private sector clinic providers in Pakistan, the Green Star Network is designed to ensure that Green Star Clinics provide high-quality family planning services at prices affordable to low-income populations. Initiated in March 1996 as a pilot project of 300 clinics, the Network has trained and certified 2,000 Registered Medical Practitioners in IUD insertion, family planning counseling, hormonal methods prescription, side-effect management, clinic management and record keeping. The IUD offered by Green Star clinics is a reversible contraceptive method that requires a trained provider for insertion. In many countries, it is the public providers who are given training and supplies, with no one to serve the private clinics. In Pakistan, where private sector clinics outnumber public clinics, PSI has stepped in to upgrade the quality of family planning care and thereby expand the number of outlets and family planning methods available to women.

In Venezuela, PSI social markets the IUD through a joint venture that it has established with PROSALUD, a dynamic Venezuelan NGO that was founded in 1991 to address the poor reproductive health of Venezuelan women. PROSALUD products, including IUDs, oral contraceptives, injectables, pregnancy test kits and condoms, are sold through a network of 5,000 pharmacies. In Nigeria and Zimbabwe, PSI social markets IUDs as a part of a long line of products, including injectables and oral contraceptives.

As of January 2007, cumulative sales of IUDs through PSI projects passed 1.7 million.

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• USAID's Maximizing Access and Quality IUD Toolkit