Providers at urban Ministry of Health facilities in Peru refer to time constraints when they justify their reticence to exchange information with clients. In this study, 27 simulated clients implementing the Service Test sought an effective contraceptive method at 19 clinics of a national sample of facilities (N=114 visits). According to the simulated clients, providers dedicated from 2 to 45 minutes to counsel them. Information exchange increased by 43 percent from low-length counseling sessions (up to 8 minutes) to medium-length sessions (9-14 minutes) but improved only slightly (less than 8 percent) with longer sessions (15-45 minutes). The offer of various method options was the most frequent provider behavior and the most highly correlated with session length while screening for contraindications showed the lowest frequency and the lowest correlation with session length. Information given to the client about action mechanisms and side effects was limited. Session durations of at least 14 minutes and a better balance of pre-choice, choice, and post-choice counseling phases are required to assure that clients exit the clinic screened for contraindications and knowing how to use the chosen method and its side effects. These findings have led Peru's Ministry of Health to design an operations research project introducing changes in several organizational systems (counseling, evaluation, training, supervision, and personnel selection).
Learning Objectives: To learn that the relationship between the amount of time providers dedicate to the family planning counseling session and the amount of information exchanged between provider and client is curvilinear and understand the practical implications of this finding
Keywords: Quality of Care,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Peru's Ministry of Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA