A silent revolution in contraception: Levonorgestrel IUS as a limiting option among rural-tribal women

As World Population Day, 11 July 2019 neared, the team at ARTH realized that over 1000 women from villages of southern Rajasthan had adopted levonorgestrel intrauterine system (LNG IUS) as a long term reversible contraceptive. ARTH has branded the service as “Mukti” and has offered the option through its clinics since August 2015 at a nominal price of Rs 499 (Rs 299 for tribal women). The same contraceptive costs Rs 5000 – 10,000 in the private health care market, and it is not available in the government system. Almost 88% of the 1116 women adopting LNG IUS already had 2 or more children, not surprisingly, 83% did not want any more children. They however chose to pay Rs 300 – 500 for a 5 year reversible contraceptive, in preference to free or incentive-laden sterilization services. What is so special about LNG IUS? It is an intrauterine device that contains no copper and works for 5 years, releasing 20 microgrammes of LNG hormone every 24 hours. This tiny quantity of hormone prevents pregnancy with a failure rate of 01-0.4% (lower than that for sterilization), significantly reduces mentrual bleeding (by 90% in one year) and hence prevents anemia, all this without side effects like cramping or excess bleeding that sometimes occurs with the Copper-T intrauterine device. To know more ARTH’s experience in introducing LNG IUS to poor rural-tribal women, click here.