Abstract: Objective: 1. To identify the key elements of IUD（intrauterine devices）services in family
planning（云孕）clinics at county and township level in western China in order to explore the reasons leading to a
higher failure rate of IUD use compared with the lower level FP clinics. 2. To provide recommendations for
enhancing FP service quality at the county level. Methods：Using situation analysis, a cross鄄sectional study
was undertaken in FP clinics within three counties, which were randomly selected out of 129 counties in
Yunnan province. Both quantitative and qualitative methods were adopted in data collection and analysis. Results: Averagely，6.17依2.55 types of IUDs were used in FP clinics at county level, while 4.08依0.92 types of
IUDs were used at township level , which showed a significant difference（Z=2.37，P=0.023）. Compared with
the clinics at township level, lower proportion of IUDs were used in FP clinics at county level recommended by
national committee based on evidences of lower failure rate. Moreover, certain types of IUD being reported a
high failure rate were still used in county level clinics. The annual number of IUD insertion cases provided by
a county FP clinics was averagely 129.83依47.42, while the number was reported 288.75依35.18 at town level,
which showed a significant difference （F=22.26，P<0.000 1）. It was implicated that weaknesses in service
management existed, such as the absence of effective communication between service providers and managers,
which may contribute to the use of inappropriate types of IUD and undermine the quality of services. Conclusions: FP clinics at county level in western China should improve service quality by controlling the
types of IUDs properly and strengthening the IUD services management.

Key words: Family planning services, Quality of health care, Intrauterine devices, Cross鄄sectional studies, YUNNAN