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APHA Scientific Session and Event Listing

Recorded presentation

Federico R. León, PhD¹, Caroline Blair, MBA¹, Ana Huapaya, BSc², Rebecka Lundgren, MA¹, Marie Mukabatsinda, Lic¹, Félix Muramutsa, Lic³, and Victoria Jennings, PhD¹. (1) Institute for Reproductive Health, Georgetown University, 7427 Javier Prado, Ate, Lima, 3, Peru, (511) 348-1262, frleon@amauta.rcp.net.pe, (2) Instituto para la Salud Reproductiva, Madrid 288, Miraflores, Dpto. 305, Lima, 18, Peru, (3) SMART Consultancy, P. O. Box 2449, Kigali, 1, Rwanda

The Standard Days Method (SD) is a new fertility awareness-based option, appropriate for women with menstrual cycles between 26 and 32 days long, that identifies days 8-19 of the menstrual cycle as the fertile window. Its introduction into the method mix of family planning programs requires training providers in SDM delivery and evaluating training outcomes. This research replicated at Rwanda Ministry of Health clinics a Peruvian study that compared SDM couseling with counseling on established hormonal methods. Targeted for on-the-job observation were providers who had received a nine-day contraceptive update on established methods and subsequent feedback, as well as two-day SDM training. To evaluate their quality of care, simulated clients implemented a service test in visits to 20 clinics. The results replicated most of the Peruvian findings. Providers routinely gave clients detailed SDM counseling: they exchanged 39 information items entailing needs assessment, method options, contraindications, mechanisms/advantages/ disadvantages, use instructions, and follow-up, which confirms that SDM counseling is generally satisfactory. On the other hand, a minority of providers posed barriers to access by refusing to give SDM tools to the client until she brought her partner for consultation, which indicates that SDM training needs adjustments. Finally, providers exchanged a significantly smaller amount of relevant information with clients who chose pills: only 27 items. That is, the same providers that excelled in the management of SDM cases under performed in pill delivery. Thus, these results suggest that the rigor of providers' pill counseling remains below capacity.

Learning Objectives:

Participants will learn that
• the detailed counseling given clients on the Standard Days Method (SDM)indicates strong provider training on this new method;
• the requirement that the partner be present during SDM counseling must be removed; and
• the less-detailed counseling received by pill clients shows that providers perform below capacity when they deliver this method.

Keywords: International Family Planning, Quality of Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation