Mona Lisa Africa
Cameroon
AUGUST 2009
PASSAGE (Project of a Joint Approach to Reproductive Health) training in Domayo Djarma
In developing the health sector strategy for 2001-2010 by the Ministry of Public Health, family planning had been identified as a priority component of reproductive health. Seen in this context, the objectives were:
- To enhance the prevalence of the use of modern contraceptive methods,
- To reduce the morbidity and mortality rates associated with early and unwanted pregnancies as well as abortions,
- To prepare individuals for harmonious family life and responsible parenthood.
We are actually still far from these objectives particularly in Maroua, the poorest region in the Cameroon, where the maternal and infant mortality rates remain very high. Thanks to the Mona Lisa Africa programme, many family planning centers could be supplied with IUDs. Unfortunately, in spite of the fact that 1000 units were sent by HRA Pharma, only 69 have been inserted.
Family planning providers and patients still know very little about the IUD. The uninformed providers unfortunately continue to play a role to belittle the image of the IUD and continue to refer to the side effects, which are in actual fact rarely seen (such as perforation of the uterus, displacement of the IUD in the uterus, risk of infection). With this in mind, members of the PASSAGE project have decided to train 13 doctors and 17 nurses in order to extend the access of IUDs into district hospitals and into certain semi-urban medical centers in Maroua. However, due to a lack of funds, the PASSAGE project could not accommodate this training. Fortunately, with the support of HRA Pharma, the theoretical training eventually took place from 13 to 14 August 2009 in the conference center of the local regional public health delegation. The practical demonstration to insert IUDs took place on the premises of the Centre for Integrated Health of Domayo Djarma. The training was done by Dr DONGMO Roger (gynaecologist/obstetrician) who is also the head of the PASSAGE project, Ms KANAWISSA Berthe (midwife nursing sister) and Dr DJAO Rebecca (regional public health delegate of the far North). The workshop organized included various themes and ended by providing the trained healthcare providers with their batch of IUDs.
The themes included:
- 1. Definition of the basic concepts (contraception, pearl index, family planning...)
- 2. The various methods of contraception and their efficacy (Dr Dongmo)
- 3. How to choose a contraceptive (Dr Dongmo)
- 4. Contraception counseling (Ms Kanawissa)
- 5. The various phases during the consultation on contraception (Ms Kanawissa)
- 6. Mechanisms of action, efficacy and duration of use of the various IUDs (Ms Kanawissa)
- 7. The advantages of the IUD (Dr Dongmo)
- 8. The main side effects of the IUD (Dr Dongmo)
- 9. List of control questions to ask patients who want an IUD insertion (Ms. Kanawissa) (20 posters were distributed to help them remember)
- 10. Technique to insert IUDs (Dr Dongmo)
- 11. Practical demonstration of IUD insertion (8 volunteer patients)
- 12. Handing out of IUDs and other necessary material to the now trained health service providers.
At the end of the training the participants showed their satisfaction with the insertion technique that they acquired and they were encouraged to go out from their side now to train their collaborators in the family planning centers.
The trainer
Examination before IUD insertion
Insertion of the IUD