FUNDAMENTALS OF FAMILY PLANNING

OBJECTIVES

By the end of this section you should be able to:

 Define family planning (FP);
 Discuss the benefits of family planning;
 Describe the essentials of family planning service provision
 Discuss family planning unmet needs

FAMILY PLANNING

Family planning is the ability to plan when to have children, and the use of birth control and
other techniques to implement such plans. Other techniques commonly used include
sexuality education, prevention and management of sexually transmitted infection, pre-
conception counseling and management, and infertility management.

Family planning is sometimes used as a synonym for the use of birth control, though it often
includes more.

Family planning services are defined as "educational, comprehensive medical or social

activities which enable individuals, including minors, to determine freely the number and
spacing of their children and to select the means by which this may be achieved

BENEFITS OF FAMILY PLANNING

Family planning enables couples and individuals to decide freely and responsibly on the
number and spacing of their children as well as on the most appropriate time of having them.

Family planning helps everyone. The health benefits of FP play a major role in protecting
and promoting the quality of lives not only of the infants, but of their siblings and the family
as a whole.

Name 3 benefits of family planning.

Medical Benefits

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Medical benefits differ depending on the target population. Some of the benefits of family
planning for women include:

 Their health is better as they are protected against unwanted pregnancy hence death
related to high-risk pregnancy and abortion is reduced;
 Some methods, such as the hormonal method, have additional (non-contraceptive
benefits), including the reduction of anaemia and cancer of the genital tract;
 Barrier methods minimize the transmission of STDs and HIV/AIDS if used properly;
 Mothers become healthier as they avoid the extremes of maternal age and carry their
pregnancies within the optimal child-bearing age bracket of 19 to 35 years, before
and after which the mothers are at high risk of developing complications related to
pregnancy;
 Decrease in the risks of abortion as the baby is welcome and the mother well
prepared physically and psychologically for the pregnancy;
 Reduced fertility and mortality rate;
 There are improved health facilities and death related to pregnancy and childbirth is
reduced.

The medical advantages to the children include:

 Healthier children, since the optimum spacing between births is 27-38 months, giving
the mother the time to nurse and care for the infant;
 Death related to infections and malnutrition to the under fives is reduced.

Social Benefits

The social benefits related to family planning are numerous and include:
 Improved relationship with the spouse and family due to less stress and better social life;
 Socially healthy families are productive and economically more stable as they participate
in community development and nation building;
 Women learn to make informed choices.

National Benefits

There are several benefits associated with family planning on a national level:

 The country is capable to budget for its citizens as the birth rate will be controlled;

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  Nationally reduced fertility and mortality rates lessen the burden to the nation.

You should note that countries with high fertility rates have poor health conditions in general,
and inadequate health facilities substantially increase the risk of pregnancy related deaths.
(Hatcher: July1997)

ESSENTIALS OF FAMILY PLANNING SERVICE PROVISION

i. Counseling

Counselling is an interactive process between the service provider and the client. Good
counselling helps clients choose and use family planning methods that suit them. Clients
differ, their situations differ, and they need different kinds of help. The best counselling is
tailored to the individual client. Service providers should be competent in counselling for all
methods of FP and should have basic counselling skills appropriate to individual clients.
ii. Provision of Family planning
All Service Delivery Points, including hospitals, health centres, dispensaries, private clinics,
pharmacies, outreach and mobile clinics should be in a position to provide FP
The health providers, including, nurses/midwives, doctors, clinical officers, pharmacists,
community based distributors (CBDs) and community health workers (CHWs) must be
specifically trained for FP

iii. Infection Prevention in FP

The basic rules of infection prevention in family planning are;

 Hand washing
 Process instruments that will be reused
 Wear gloves
 Do pelvic examinations only when needed
 For injections, use new auto-disable syringes and needles
 Wipe surfaces with chlorine solution
 Dispose of single-use equipment and supplies properly and safely
I will refer you back to module 1 unit 1 for more details on infection prevention.
iv. Managing contraceptive supplies
Good-quality reproductive health care requires a continuous supply of contraceptives and
other commodities.
Accurate and timely reports and orders from providers help supply chain managers
determine what products are needed, how much to buy, and where to distribute them.
Clinic staff members do their part when they properly manage contraceptive inventory,
accurately record and report what is provided to clients, and promptly order new supplies
v. Logistics

Contraceptive logistics responsibilities of clinic staff include these common activities:

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Daily
 Track the number and types of contraceptives dispensed to clients using the
appropriate recording form
 Maintain proper storage conditions for all supplies:
 Provide contraceptives to clients by "First Expiry, First Out"(FEFO)

Regularly (monthly or quarterly, depending on the logistics system)

 Count the amount of each method on hand in the clinic and determine the quantity of
contraceptives to order
 Work with any community-based distribution agents supervised by clinic staff,
reviewing their consumption records and helping them complete their order forms.
 Report to and make requests of the family planning program coordinator or health
supplies officer (typically at the district level), using the appropriate reporting and
ordering form or forms.
 Receive the ordered contraceptive supplies from the clinic pharmacist or other
appropriate person in the supply chain.
vi. Follow up and Referral System

All clients who choose a method of FP should be informed of the appropriate follow up
requirements and encouraged to return to the clinic in case of any concerns. Providers
should use the established referral system for appropriate management of identified
conditions that need further attention.

vii. Supervision
Supervision ensures that the guidelines are being followed and client needs are being met. It
helps in the assessment of the quality of care given and whether the client’s rights are being
observed. Furthermore, it motivates service providers as they can express and discuss
views with their superiors. Continued supervision will enable you to pinpoint areas for
improvement.
viii. Cost considerations for clients:
The service provider must keep in mind that provision of FP services involves both financial
and opportunity costs. The client’s financial circumstances must be considered and the cost
effectiveness of various available contraceptive methods discussed with the client.

Family Planning Unmet Need

The contraceptive prevalence rates for all family panning methods and modern methods
were estimated in 2003 at 39% and 32% respectively. The Kenya Service Provision
Assessment (KSPA) survey indicates that only 73% of all health facilities are offering
temporary methods of family planning services

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Unmet needs for family planning among married women in Kenya has remained high, at
about 24% since 1998. The number of unmarried sexually active individuals in need of family
planning information and services is also growing.

The key challenges in addressing these unmet needs are;

 Lack of securities for contraceptive commodities
 Lack of sustained demand creation for family planning services
 Low community and private sector participation in family planning service provision
and low involvement of males
 Method mix that does not permit wide method choice and cost effectiveness
 Inadequate family planning training for service providers
 Low level of integration of family planning with HIV/AIDs services.

To reduce the unmet need for family planning, the following can be done;
 Create sustained demand for family planning services
 Guarantee contraceptive commodity security
 Promote increased involvement of men in family planning, including increased use of
male methods for improved family planning services uptake
 Promote participation of communities, including the private sector in provision and
financing of services at all levels
 Ensure strengthened reproductive health service delivery systems at all levels to
improve efficiency, quality and integration of family planning and HIV/AIDS services
 Promote social marketing of contraceptives to increase access through non-formal
channels.