The 130th Annual Meeting of APHA

Abstract #50796

Federico R. León, PhD, FRONTIERS IN REPRODUCTIVE HEALTH, Population Council, Lima, Los Libertadores 533, Of. 304, San Isidro, Lima, L-27, Peru, 348-6559, frleon@amauta.rcp.net.pe

In the counseling process, Peru MOH family planning providers pay too much attention to irrelevant methods and relatively little to the method chosen by the client. A Balanced Counseling Strategy centered on friendly method cards for providers and exhaustive method pamphlets for clients was designed. The provider ought to 1. Put client need diagnosis at the service of method choice by discarding irrelevant methods (e.g., the tubal ligation and vasectomy cards if the client is a spacer). 2. Further avoid client information-overload by concentrating on 4-item descriptions contained on the surviving method cards. 3. Focus in-depth on the method chosen by the client by referring to the contents of the method pamphlet. The strategy was evaluated by means of a true experiment that used 24 health directorates as units of analysis and included workshop-type interventions that targeted providers and their supervisors. The quality of care was improved by 1.3 standard deviations (sd) to 2.7 sd, depending on the indicator. The immediate impact on client knowledge of method chosen ranged from 0.2 sd to 0.7 sd and consultation time under typical performance was increased by 1.1 sd. The strategy showed extraordinary potential. Experimental providers who actually used both method cards and method pamphlet in counseling (only one third) improved their performance at much higher levels and at lesser relative cost. Second, the evaluation did not capture longer-term effects of the use of the method pamphlet by the client at home. An institutionalization of the strategy is needed to extend these benefits to more providers and their clients.

Learning Objectives:

• Recognize that providers should and can use a more balanced counseling strategy, that job aids are instrumental in improving the quality of care, and that further efforts are needed to make benefits universal.

Keywords: Quality of Care, Reproductive Health

Presenting author's disclosure statement:
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.