Reaching men when they're not present: The effect of an “It Takes Two” approach to family planning counseling with women

Research has suggested that couple communication and male support for family planning have a positive effect on method satisfaction and use. Is there anything family planning providers can do in the context of a short family planning visit when the man is not present to promote these behaviors? Georgetown University conducted a study with Tri-City Health Center in Fremont, CA, to test whether a streamlined intervention that included training providers to incorporate key partner-related questions into counseling and offering educational materials geared for men and couples would increase providers' sensitivity to the couple relationship and positively impact family planning satisfaction and use. The Standard Days Method, a method requiring couple communication, was incorporated into the method mix to further sensitize providers to couple issues. Data was collected before and after the intervention in the form of provider interviews, client interviews, partner interviews, and mystery client visits. Baseline data indicated that while the overall quality of counseling was high, only 52-56% of clients reported that the provider asked how her partner felt about birth control or whether she would like information for her partner. Simulated client visits showed a similar disparity. While couple communication was high, only 20% of clients reported that their partner helped them with method use. Post intervention data show greater provider-client interaction related to partner issues. A trend in increased method satisfaction and male involvement in method selection and use was observed, however the size of the cohort was small. The applicability of these results for other family planning programs will be addressed.