Papaya-based pelvic trainers

a low-cost innovative model for IUD insertion training

Abstract

Problem: The copper intrauterine device (IUD) is one of the most effective contraceptive strategies. It is a long-acting reversible method, whose effect lasts for 12 years and does not depend on the woman’s action to guarantee its effectiveness. However,  despite being widely distributed  by the Unified Health System, there is low adherence to it; the choice of contraceptive methods with efficacy conditioned on their perfect use     is more prevalent. There are several barriers to this situation, one of which is the reduced offer of the contraceptive insertion by family health teams. Therefore, expanding access to effective family planning through the development and implementation of multiplier training workshops for IUD insertion, with low operational costs and easily reproducible, was the strategy adopted. Methods: Two steps were carried out. First, a theoretical explanation was made covering the characteristics of contraceptive methods and the approach to family planning based on the Patient- Centered Clinical Method. Then, the procedure technique was demonstrated in videos and subsequently applied to the pelvic simulation model with papayas. Results: The acquisition of skills and competencies was assessed subjectively, with feedback from participants reporting confidence in implementing and executing IUD insertion, and objectively, with the actual inclusion of this procedure in their routines in primary care units. Conclusions: It is understood that the lack of qualified professionals to offer and insert the copper IUD contributes to the low prevalence of use of the method in Brazil, which is around 2%. The training in papayas represents a low-cost and effective way to train doctors and nurses, allowing the replication of this experience and, consequently, more people having easier access to effective and safe methods of contraception.