Consult & Choose: A Client Centered Approach to Family Planning Counseling Leads to High Patient Satisfaction

This issue of Communication Impact describes an evaluation of the Consult & Choose (CC) Family Planning (FP) Initiative in Jordan, a project of the Jordan Health Communication Partnership (JHCP) with funding from the United States Agency for International Development (USAID). As part of the "Hayati Ahla" family planning (FP) campaign, "the CC Initiative produced a video modeling correct and incorrect interpersonal communication approaches and held training sessions with Ministry of Health (MOH) Maternal and Child Health (MCH) providers. The trainees reviewed effective counseling approaches and learned how to use the counselling communication tools". These included posters, the providers' handbook, cue cards for use with patients, and take-home materials for clients. The initiative also produced a video entitled "Hayati Ahla" in collaboration with the MOH, which provides information about FP, including information about modern methods, reproductive health and the advantages of birth spacing, among other topics.

In 2011, the initiative conducted exit interviews in Irbid, Jordan, with 461 women who visited one of 2 MCH centres that participated in the CC Initiative for FP counselling or follow-up.

• Client satisfaction with FP services at these centres was very high, with 95% of clients willing to recommend the centre they had visited to their relatives or friends. 82% of women reported that they were very satisfied with their visit to the health centre.
• Comparing satisfaction of clients for whom the communication counselling tools were used: 
  • Among those who reported that the tool called the FP eligibility wheel was used during the visit, 89% reported being "very satisfied," compared to 73% of those who reported that the wheel was not used. 
  • Similarly, 84% of those who reported use of the cue cards were "very satisfied" compared to 71% of those who did not report use of the cue cards during their visit.
• Clients were also significantly more likely to be "very satisfied" when the provider followed the "Hayati Ahla" FP counselling guidelines, demonstrating the importance of each step described in the "Consult & Choose" tools. "The fact that providers were significantly more likely to ask clients about their desired family size, explain the advantages and disadvantages of the various methods, and discuss side effects when they followed the 'Hayati Ahla' counseling protocol is likely to have contributed to the overall satisfaction."
• "The majority of women who reported watching the 'Hayati Ahla' video reported that it affected them (85%), over one-third of whom reported that they will use FP methods as a direct result of viewing the film. Importantly, all of the women said they will tell others about the film and 100% of the women believed that the video should be shown in all health centers."

The study concludes that CC materials should be more widely distributed in Jordan and other middle-income countries, coupled with training doctors, midwives, and FP counselors in the "Hayati Ahla" campaign's CC counselling approach.