Despite reliable evidence of intrauterine devices’ safety and effectiveness, this contraceptive method remains under-utilized in many countries due to persistent fears that it causes pelvic infection. This study aimed to assess IUDs’ knowledge and acceptability among clients and providers in our family planning services and identify barriers to use.

A descriptive cross-sectional survey was conducted at eight family planning clinics in Cape Town, South Africa. Two hundred sixteen clients and 30 providers from the same clinics were interviewed using structured questionnaires.

The IUD’s awareness among clients was low: 41% had heard of this contraceptive method. Ever and current use was shallow. Only 4% had ever used an IUD, and three women were still using this method. Many women cited lack of knowledge as an obstacle to using. Among providers, factual knowledge about IUDs, infection, and increased menstrual bleeding were frequently mentioned as disadvantages of the method.

The study concluded that although the IUD is available free of charge in our public sector services, it is not utilized. Clients lacked knowledge of this method, and research evidence had not impacted providers’ ability and practice. Ongoing both clients’ and providers’ education is essential to improve the accessibility and acceptability of this safe and effective contraceptive method.