The Koyang experience indicates that acceptance of th IUD is heavily dependent on mainly two factors; first the distance from the village to the IUD service and secondly the extent of side reactions and bad rumors about its use in the community (village).
While the distance problems were solved by sending out mobile teams or by establishing new clinics in the villages, the problem of side reactions and/or bad rumors which create an unfavorable atmosphere still remains. This led to the mothers' class experiment.
Mothers' classes were organized as an adequate educational program for the public with the proper educational materials to offset rumors and to make a better atmosphere for accepting and retaining the IUD.
The universe of this project (mothers' class) was the population of Koyang County including 143 villages (76,810 population).
All village in the county village were selected at random from each stratum, with probability proportionate to the number of villages in township and taking into account geographic location to avoid concentration of sample villages in one area in a township.
In 13(area Ⅰ) out of 27 villages, special education was conducted by the family planning workers with pictorial charts stressing the two sided communication explained above on advantages and disadvantages of the IUD, and with mild fear-arousing content on the side effects of induced abortion. In the 14 villages of area Ⅱ, general education for family planning and maternal-child health was given.
As the results, in the low IUD acceptance area IUD acceptance rate during the study period was 14.4 per 100 eligible women in the experimental areas while it was 7.1 in the control areas, and the experimental areas Ⅰ had 21.5 versus the experimental areas Ⅱ had 11.5 per 100 eligible women. These results show that experimental areas had higher IUD acceptance rate than in control areas, and areas Ⅰ had more IUD insertions than in areas Ⅱ with significant differences respectively. However, there were no differences in IUD acceptance among the experimental, Ⅰ, Ⅱ and control areas in the high IUD acceptance areas.
IUD termination rates during the study period were compared among the experimental Ⅰ, Ⅱ and control areas, total termination rates during nine months of use were 32.3%, 37.5% and 41.3% respectively which shows the lowest rate in experimental areas Ⅰ.
Termination rate due to removal was lower in the experimental areas Ⅰ and Ⅱ (19.8%, 19.1% in nine months of use) than that of control areas(30.6% in nine months of use) with positive change of attitude toward IUD practice particularly in experimental areas Ⅰ where more eligible women are practicing family planning.