This document describes contraceptive methods available in Sudan. It provides definitions of contraception and a brief history of family planning in Sudan. The main modern contraceptive methods available are oral contraceptive pills, injectable contraceptives like DMPA, and IUDs. Barrier methods like condoms are available but not widely accessible. Emergency contraception and other methods like implants, diaphragms, and female sterilization are generally not available. Utilization of contraception in Sudan remains low at around 9% due primarily to cultural and religious factors as well as limited access in rural areas. Recommendations include improving access to condoms, emergency contraception, and female-oriented methods.

1. Description of available
contraceptive methods in Sudan
By
Dr. Sami Mahmoud Abdelkhair
Dr. Waled Amen Mohammed
Geneva Foundation for Medical Education and Research
GFMER Sudan 2012
Forum No: ( 3 )

2. Name of presenters
Name Position Institution
Sami Mahmoud Abdelkhair Consultant Obstetrician & Gynae. RHC
Waled Amen Mohammed Head, Community Health Nursing UMST
Name of contributors
Name Position Institution
Sami Mahmoud Abdelkhair Consultant Obstetrician & Gynae. RHC
Waled Amen Mohammed Head, Community Health Nursing UMST

3. Contents of the presentation
• Introduction
• Definitions
• History
• Methods of contraception.
• Recommendations
• Conclusions
• Références

4. Introduction
• Family planning is an important strategy in
promoting maternal and child health.
• It improves health through adequate spacing of
birth and avoiding pregnancy at high-risk
maternal ages and high parities ,(Umbeli, 2010).
• The total fertility rate for the Sudan has fallen
from 5.4 children per woman to 4.6 in the
period 1995-2000 and is estimated at the same
rate in 2006 (SHHS, 2006).

5. Definitions
• What is Contraception ? Contraception is
the intentional prevention of pregnancy
during sexual intercourse. Birth control is
the device and/or practice to decrease the
risk of conceiving, or bearing, offspring.
With the wide assortment of birth control
options available, it is possible for a
woman to use several different
contraceptive methods at various stages
throughout her fertile years.

6. History of Family planning
in Sudan
• Family planning services were initiated
in 1965 when the Sudan Family
Planning Association was founded. The
first thing in 1964 by pioneers such as
Prof. Alatabani (Director) and
Prof.Awatif A. Osman ( General
Secretary).

7. History of Family planning in
Sudan
• In 1975, the Ministry of Health
established the maternal and child health
and family planning project followed by
the Sudan Fertility Control Association in
1976.
• Family planning services were integrated
into the Primary Health Care System in
1985.

8. Methods of Contraception
• Block the sperm from reaching the egg
• Kill or damage sperm
• Keep eggs from being released each month
• Change the lining of the uterus so the
fertilized egg does not attach to it
• Thicken the mucus in the cervix so sperm can
not easily pass through it

9. IDEAL CONTRACEPTIVE
•Effective • Available
•Safe • One time
method
•No C/I
• Acceptable
•cheap
• reversible

10. Availability of contraceptive
methods in Sudan
• Barrier Methods:
1. Male condom: is now available as a
counter-drug in many private pharmacies.
It is not available in the PHC facilities or even in
HIV management centers.
There is a lot of religious & political dilemmas
about male condom use in Sudan

11. Availability of contraceptive
methods in Sudan
2. Other types of barrier methods
are not available like :
• Female Condoms
• Spermicidal Sponge Diaphragm
• Cervical cap

14. Availability of contraceptive
methods in Sudan
• Spermicides often are used in suppositories,
foam, cream, jelly, and film (thin sheets that
contain spermicide) to kill sperm or make
them inactive.
• All forms of Spermicides are not available in
Sudan now , however they were used 5 years
ago by Sudan Family planning Association.

16. Availability of contraceptive
methods in Sudan
• Hormonal birth control :comes in
several forms, pill, skin patch, vaginal ring,
injection, hormonal IUD and implant.
• Only three types are available
1. Birth control pills
2. Injection of depot medroxyprogesterone
acetate (DMPA)
3. Implant

17. Birth control pills
• Birth control pills are two types
1. Progesrtone only pills (POP) like Exulton &
Cerazette tabs
2. Combined oral contraceptives (COC) like
Microgynon, Marvelon & cilest.
Both types are available in Sudan but not for
free for patients.

19. Applicator

20. implants
• Adopted by FMH in 2010
• Now used mainly in Khartoum state.
• UNFPA has sponsored it at the level PHC
facilities.
• It cost 80 SDG for the patients.
• The insertion cost will reach 200 SDG.
(DKT International, 2012)

21. Intra-Uterine Device IUD
• small, T-shaped, plastic device that is inserted
and left inside the uterus to prevent pregnancy.
There are two types : the hormonal IUD
(Mirena) and the copper IUD.
• The IUD does not protect against STDs.
•

22. Emergency Contraception
• There are two types of emergency
contraception :
1. Plan B
2. the IUD
• There is no Plan B available in Sudan.
• IUD is very rarely used as emergency
contraceptives.

23. IUD supply
• DKT company is the main supplier for IUD in
the country.
• Hospital , health centers as well as SFPA are
buying the IUD from DKT for 5 SDG , but
actually the patient had the service for 40
SDG.
(DKT International, 2012)

25. Surgery for Contraception
1. TUBAL LIGATION
2. VASECTOMY

26. Tubal ligation
• Done by three methods:
1. During C/S ( Done frequently in Grand-
multipara with many scars).
2. With mini-lapratomy
3. During Laparoscopy with special clips

27. THESE CLIPS ARE NOT AVAILABLE IN
SUDAN.

28. Vasectomy
Vasectomy
Is not
practiced
In Sudan
For Religious
reasons

29. Utilization of Family
planning Methods in Sudan
• The percentage of women using modern
methods of contraception in Sudan rose, for
example, from four percent in 1977-1978 to six
percent in 1989 and seven percent in 1992-1993.
• The utilization rate remains low at 9 % in 2005
which is among the lowest in the world. (WHO,
2007).
• Millennium Development Goals (MDGs) report
2012 stated that the prevalence rate is still the
same in Sudan at 9%. (UNDP-Sudan, 2012).

30. Uses of Contraceptive methods
(Ibnouf, 2007).
Percent
47.7
10.2
7.5
Pills IUD Injections

31. Uses of Natural methods
(Ibnouf, 2007)
Percent
33
16.1
3.6
1
Breast feeding Rhythm Withdrawal Condom

32. Uses of Contraceptive methods
(SHHS, 2010).
Other .2
Withdrawal .0
Periodic abstinence/Rhythm .3
Lactational amenorrhoea method (LAM) .3
Diaphragm/foam/jelly .0
Female condom .0
Male condom .1
Pill 6.3
Implants .0
Injectables .9
IUD .5
Male sterilization .0
Female sterilization .3

33. Recommendations
• More liberal Condom provision
• Emergency contraception
• Female condoms
• Spermicidal.
• Improve laparoscopy service

34. Conclusion
• Fertility rate in Sudan is still high mainly in rural
settings. The utilization of contraceptive methods is
low especially modern ones. The most frequently
used methods are oral contraceptive pills followed
by intrauterine devices and injections.
• — access to contraceptive methods in Sudan is
The
available for years. Some study reflects lacking
knowledge about the methods for controlling birth.
• The most common challenges for women to utilize
contraceptive methods are
culture, religion, taboos, urban-rural availability of
services and men dominant in decision making.

37. References
Taha Family planning practice in Central Sudan. Khartoum: Department of Community
Medicine, College of Medicine, University of Juba, Sudan; 2010 [cited 2012 Aug].
Available from: Family Planning- Dictionary.com
WHO. Contraceptive methods 2007
UNDP-Sudan. Status of Millennium Development Goals in Sudan. Report. New York:
UN; 2012 July.
Federal Ministry of Health. Sudan Household Health Survey. Sudan; 2006
Ibnouf AH, Maarse JAM, Borne VD. Utilization of family planning services by married
Sudanese women of reproductive age. Eastern Mediterranean Health Journal. 2007;
13(6).
Bulatao RA. 2007 [updated 2007; cited Aug 2012]; Available from: www.who.org
Umbeli T, Mukhtar A and. Abusalab. M.A. Unmet needs for family planning in
DarAssalam, Sudan. Health Journal. 2005 4 May; 11:4
DKT International. Ensuring the right for all to quality family planning options since
2005; 2007