Promote Family

planning counseling

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 Learning objectives

At the end of this lesson ,the students will be able to:

• Define counseling
• State the purpose of counseling
• Explain the principles of counseling
• Describe the qualities of good counseling
• Explain the steps in the counseling process

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 What does mean counseling?

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 Concept of counseling
• Counseling is a type of client-provider interaction that involves
two-way communication between a health care staff member
and a client,
• For the purpose of facilitating an informed decision by the client
or helping the client address problems or concerns.
• Counseling helps clients to choose a method that is personally
and medically appropriate
• Counseling helps clients to understand how to use,
• It helps users to use correctly and consistently
• The client and service provider give and receive relevant,
accurate, & complete information

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 Counseling…….
• Counseling is an ongoing process and must be part of every
client-provider interaction in health care delivery.

• The decision to adopt a particular method must be a voluntary,

informed decision made by the client.

• It is the responsibility of the service provider to ensure that the

client is fully informed and freely chooses and consents.

• The sensitive nature of family planning requires that clients'

right to privacy, confidentiality, respect, and dignity are
always ensured.

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 Family planning counseling
• Couples counseling refers to counseling sessions in which a
woman and her partner are present in discussions with the
provider.
• All of the information and skills presented in this unit for
counseling individuals may be applied to couples counseling.
• Counseling is not:-
 Telling a client what to do or making decisions for client
 Judging, blaming, or lecturing a client
 Imposing your beliefs
 Pressuring a client to use a specific method
 Lying to or misleading a client

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 What is Purpose of counseling?

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 Purpose of counseling
1. When the client-provider interaction is positive and the client
feels that s/he was actively involved in the choice of method, the
chances are increased that s/he will:
 decide to adopt family planning
 use the method correctly
 continue to use the method
 cope successfully with minor side effects
 return to see the service provider
 not believe myths or rumors and even work to counteract them
among family and community
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 Purpose of counselling…..
2. A well-informed, satisfied client also has advantages for the
service provider due to:
 higher continuation rates
 fewer time-consuming minor complaints and side effects
 satisfied clients often promote family planning and refer other
clients
 increased trust and respect between client and provider

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 Types of family planning counseling

1. General Counseling
 Usually takes place on first family planning visit

• Needs of clients discussed

• Client concerns addressed
• General information about methods/options given
• Questions answered
• Misconceptions/myths discussed

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 Types of family planning counseling
2. Method-specific Counseling
 Decision-making and method choice made
 More information on method choice given
 Screening process and procedures explained
 Instructions about how and when to use method given
 What to do if there are problems discussed
 When to return for follow-up discussed
 Return/Follow up counseling is arranged

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 3. Return/Follow up counseling

 Problems and side effects discussed and managed

 Continuing use encouraged unless major problems exist
 Instructions should be repeated
 Questions answered and client concerns addressed

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 4. Individual counseling
 Appropriate when privacy and confidentiality are necessary
 Greet in a friendly manner
 Listen to client's reason for coming
 Ask about client's reproductive health and medical history
 Ask client what they know about family planning and explain
family planning methods, including advantages,
disadvantages, and possible side-effects
 Encourage questions and help client choose method
 Explain to client how to use their chosen method
 Ask client to repeat back key information
 Schedule a return visit

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 5. Group counseling

• Appropriate when clients are more comfortable in a group

situation or when individual counseling is not feasible
• Greet clients in a friendly manner
• Introduce benefits of family planning
• Elicit and discuss rumors and concerns about family planning
• Discuss family planning methods and encourage questions and
group discussion
• Discuss how to obtain appropriate methods

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 Principle of counselling
providers should follow these guidelines when counseling clients:
• Create an atmosphere of privacy, respect, and trust.
• Engage in two-way communication with the client.
• Ensure confidentiality.
• Remain non judgmental about values, behaviors, and decisions
that differ from your own.
• Show empathy for the client’s needs.
• Demonstrate comfort in addressing sexual and gender issues.
• Provide reliable and factual information tailored to the needs of
the client.
• Support the client’s rights to sexual and reproductive health.

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 Why counselling is important?

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 Why counselling is important?
 It protects clients right to informed and voluntary decision
making.
 It is an essential element of quality service
 It is a key determinants of the adoption and continuation of
family planning

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 Elements of good counseling
 Focus on the woman's needs and knowledge
 Assess the context of the problem with the woman
 Actively listen and learn from client
 Engage in interactive discussion
 Utilize skilled ways of asking questions
 Explore situations and beliefs
 Do not be judgmental
 Build trust
 Explore options together
 Facilitate problem-solving

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 IEC in family planning
Family Planning clients have right to freely choose
Whether to:
• Have children, and how many to have
• Use FP or not
• Be tested for STIs/ HIV
• Use condoms
• Talk with partner about condoms or FP
• Reveal their HIV status

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 Principle of counseling
1.Treat each client well
 Be polite
 Respect every client
 Create a feeling of trust
 Be open to sensitive matters
2. Interact
 The provider should listen
 Understands the clients
 desire
 Situation
 Encourage the client to talk & ask

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 Principle of counseling…..
3. Tailor information to the client
 Listen & give what information the client needs in language
that the client understands
4. Avoid too much information
 Give information to make informed choices
 Too much information hard to remember
 The provider will spent much time & little time will be left for
the client’s question, concerns & opinions
 Start counseling from what the clients know before
 Delivering too much information is called “information
overload”

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 Principle of counseling….
5.Provide the method client wants
 Help the client to make informed choice
 Respect the clients choices
 Correct any mistaken ideas gently
 Make client to consider other choices & compare them
 If there is no medical reason against it, clients should have the
method what they want
 This makes them to use the method more longer

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 Principles of counseling….
6.Help the clients understand & remember
 Show sample FP materials
 Encourage the client to them
 Show how they are used
 Check the client understands the method
 The advantages & disadvantages
 Explain flip charts and posters
 Give printed materials

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 Topics to be covered on FP counseling

 Effectiveness of methods
 Advantages and disadvantages
 Side effects and complications
 How to use
 STD prevention
 When to return

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The basic rights of all family planning clients:
1. Information: The right to learn about the benefits and
availability of family planning.
2. Access: The right to obtain services regardless of sex, creed,
color, marital status, or location.
3. Choice: The right to decide freely whether to practice family
planning and which method to use.
4. Safety: The right to be able to practice safe and effective family
planning.
5. Privacy: The right to have a private environment during
counseling or services.
6. Confidentiality: The right to be assured that personal
information will remain confidential.

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 The basic rights…..
7. Dignity: The right to be treated with courtesy, consideration,
and attentiveness.
8. Comfort: The right to feel comfortable when receiving services.
9. Continuity: The right to receive contraceptive services and
supplies for as long as needed.
10. Opinion: The right to express views on the services offered.

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 Family planning counseling approaches

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 REDI Framework
REDI stands for
R- Rapport building,
E-Exploration,
D-Decision making, and
I-Implementing the decision.
The REDI framework:
 Emphasizes the client’s right and responsibility for making
decisions and carrying them out
 Provides guidelines to help the counselor and client consider the
client’s circumstances and social context

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 phases and steps of REDI
Phase 1: Rapport Building
1. Greet client with respect
2. Make introductions (identify category of the client—i.e., new,
satisfied return, or dissatisfied return)
3. Assure confidentiality and privacy
4. Explain the need to discuss sensitive and personal issue
Phase 2: Exploration
for new clients
1. Explore in depth the client’s reason for the visit
2. Explore client’s future RH-related plans, current situation, and
past experience
3. a. Explore client’s reproductive history and goals, while
explaining healthy timing and spacing of pregnancy
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 Steps of REDI…..
b. Explore issues related to sexuality
c. Explore client’s history of STIs, including HIV
d. Explain STI risk and dual protection, and help the client perceive
his or her risk for contracting and transmitting STIs
4. discuss the client’s preferred method, if any, or relevant FP options
if no method is preferred, give information as needed, and correct
misconceptions
5. Rule out pregnancy and explore factors related to monthly
bleeding, any recent pregnancy and medical conditions

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 Steps of REDI…..
for returning clients
1. Explore the client’s satisfaction with the current method used
2. Confirm correct method use
3. Ask the client about changes in his or her life

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 Steps of REDI…..

Phase 3: Decision Making

1. Identify the decisions the client needs to confirm or make
2. Explore relevant options for each decision
3. Help the client weigh the benefits, disadvantages, and
consequences of each option
4. Encourage the client to make his or her own decision

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 Steps of REDI…..
Phase 4: Implementing the Decision
1. Assist the client in making a concrete and specific plan for
carrying out the decision(s)
• (obtaining and using the FP method chosen, risk reduction for
STIs, dual protection, and so on)
2. Help the client develop skills to use his or her chosen method
and condoms
3. Identify barriers that the client might face in implementing his or
her decision
4. Develop strategies to overcome the barriers
5. Make a plan for follow-up and/or provide referrals as needed

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 Family planning counseling approach…

2. The GATHER approach

G = Greet the client respectfully.
A =Ask them about their family planning needs.
T = Tell them about different contraceptive options and methods.
H = Help them to make decisions about choices of methods.
E = Explain and demonstrate how to use the methods.
R = Return/refer; schedule and carry out a return visit and follow
up.
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What does effective counseling do for FP
clients?

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Importance of effective counseling for FP clients

• Enable clients to choose a method that suits their needs

• Enables clients to use their chosen method correctly
• Informs and prepares clients for side effects
• Enables clients to continue using an FP method with satisfaction
as long as they want it
• Enables clients to reach and maintain their reproductive health
goals

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 Who Are Our Clients?
• Providers need to quickly assess individual clients’ needs so they
can serve them in an efficient manner.
• Understanding who the client is and what his or her needs are
helps the provider tailor the counseling accordingly.
• Clients can be categorized in different ways
For example:
 New versus returning clients
 • Clients returning for resupply and/or routine follow-up versus those
returning with problems
 • Clients wishing to limit childbearing versus those wishing to space
births
 Clients with special needs associated with a recent pregnancy (e.g.
postabortion and postpartum)
 • Special population groups (e.g., adolescents, men, people who are
HIV-positive)
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 Factors Influencing Counseling Outcomes
 In every client-provider counseling session, many and various
factors influence the outcome of the counseling.
 These factors should all be taken into consideration when
conducting counseling.

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 Service provider factors
 Provider attitudes and behaviors
 Style of provider (mutual participation model vs. authoritarian
or provider-controlled model)
 Provider knowledge and skills (communication and technical)
 Provider method bias
 Differences in client-provider caste, social class, gender, or
education

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Client Factors

 Ability to obtain method of choice, or second choice if

precautions exist

 Level of trust and respect towards provider

 Feels privacy and confidentiality are assured

 Feels s/he is being treated with respect and dignity

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Programmatic Factors

 Number of methods available

 Reliability of method supply (especially in the case of COCs
or DMPA)
 Privacy and confidentiality of surroundings
 Social/cultural needs are met
 Overall image of professionalism conveyed by clinic and
provider

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Barriers / challenges of FP method use
Demand factors
• Lack of Information/Knowledge
• Health Concerns and Side Effects
• Interpersonal Relations
• Socio-cultural Barriers
Supply Side Factors
• Method Mix and Services
• Attitude and Skill of Health Service Providers
• Medical Barriers
• Physical and Financial Barriers
• Policy Gaps

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 THANK YOU!!!

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