RESUMO
PIP: When India began its IUD program in 1965 the number of acceptors, th eir youth, and their low parity compared favorably with acceptors in Korea and Taiwan, but by 1972 only a negligible percentage were covered by IUDs and India as a whole had almost discontinued the program. The problem seemed to be the poor screening of initial acceptors with many more women being included than should have been and the poor follow-up. South Korea and Taiwan have organized programs of individual attention, which India lacked. Up until 12 months the retention rates among Indian women were similar to those of South Korea and Taiwan, but after 12 months the problems of bleeding, for which they were not prepared, and pain took their toll. It was assumed that women with problems would go back to a clinic for help, but rural Indian women are used to taking care of themselves and they removed the "bloody" device themselves. This bleeding raised panic among the masses. IUD programs must allow for individual follow-up and in that sense cannot be mass programs. 60% of those who discontinued shifted to another contraceptive method, sometimes producing a baby in the meantime. Sterilization was the most common new method. 40% used no contraception. 2100 insertions in rural Maharashtra state prevented 468 births with a retention of 3087 years in all. IUD use does not significantly lower the birthrate, even in countries like Korea. However, IUD users tend to stay with the method longer, but they are more likely to use another method when they discontinue, and the IUD can be adopted early in the reproductive years. However, acceptors must be warned about possible side effects and better follow-up must be an integral part of the program.^ieng
