Family Planning Counseling

Overview of stages of counseling

General counseling

This is the first contact of family planning counseling .it involves counseling on general issues to address the client’s needs and concerns.

The counselor needs to talk about the following:

• To give general information about family planning methods
• To clear up any mistaken belief or myths about specific family planning methods 
• Give information on other sexual and reproductive health issues like; STD’s, HIV and infertility

All these will make the client arrive at the informed decision on the best contraceptive method to use.

Method-specific counseling

The information is given about the chosen method.

The following points are considered:

• Examination for fitness (screening) (Blood pressure, weights, age and other health parameters)
• Instruct on how and when to use given method
• Tell the client when to return for follow-up and ask them to repeat what you have said on key information.

BRAIDED,

Family planning counseling the BRAIDED approach, the acronym BRAIDED can help to remember what to talk about when counseling clients on specific methods.

It stands for:

B-Benefits of the method

R-Risks of the method including consequences of the method failure

A-Alternative to method, including abstinence and no method

I-Inquiries about the method (Individual rights and responsibilities to ask)

D-Decision to withdraw from a method without a penalty

E-Explanation of the method chosen

D-Documentation of the session for your own records

Return follow-up 

Follow-up counseling should always be arranged after the counseling process.

The aims;

• To discuss and manage any problem and side effects related to the given contraceptive method
• It gives the opportunity to encourage the continued use of the chosen method unless problems exist.
• It helps to find out whether the client has other concerns  and questions 

Steps in family planning counseling GATHER approaches  

The counseling process should follow a step-by –step process.

GATHER acronym will help you remember the 6 steps for family planning counseling.

G-Greet the client respectfully

A-Ask them about their family planning needs

T-Tell them about different contraceptive options and methods

H-Help them to make decisions about choices of methods

E-Explain and demonstrate how to use the methods 

R-Return /Refer, schedule and carryout a return visit and follow-up

It is important to give more emphasis to the points during counseling steps 

Greet the client 

• In the first case give your full attention to your client
• Greet them in respective manner and introduce yourself to them often offering seats
• Ask them how you can help them 
• Tell them that you will not tell others what they have told you.
• If the counseling takes place in health facility you have to explain what will happen during the visit describing physical examinations and laboratory tests if necessary
• Conduct counseling in a place where no one can overhear your conversation

Ask

• Help them to talk about their needs, doubts, concerns, and any question they might have
• If they are new ,use a standard check list or from your health management information system to write down their names, age ,marital status ,number of pregnancies ,number of births, number of living children ,current and past family planning use  and basic medical history
• Explain that you are asking them the information in order to help you provide appropriate care
• Keep questions simple and brief, and look at them as you speak

Many people do not know diseases, ask specific questions,  say<< have you had any headache in the past 2 weeks? or have you had any genital itching? Or do you experience any pain when urinating?>> do not say <<have you had any disease in the recent past?>>

If you have seen the client previously, ask if anything has changed since the last visit.

Tell

• Tell them about family planning method 
• Tel them which methods available
• Ask them which methods interest them and what they know about the method 
• Briefly, describe each method of interest and explain how it works, its advantages, disadvantages and possible side effects.

 Help

• Help them to choose a method of contraception, ask them about their plans and family situation, if they are uncertain about the future start with the present situation
• Ask what the spouse /partner likes and wants to use
• Ask if there is anything they cannot understand and repeat information when necessary
• When the chosen method is not safe for them explain clearly why the method may not be appropriate and help them choose another method.
• Check whether they have a clear decision and ask what method have you decided to use?

Explain

• Explain how to use a method after it has been chosen
• Give supply if appropriate 
• If the method cannot be given immediately, explain how, when and where it will be provided 
• For the method like voluntary sterilization the client will have to sign consent form .the form says that; they want the method, have been informed about it, and understand the consent form.
• Explain how to use the method 
• Ask the client to repeat the instructions
• Describe and possible side effects and warning signs and tell them what to do if they occur.
• Ask them to repeat this information back to you 
• Give them printed material about the method to take home if it is available
• Tell them when to come back for a follow-up visit and to comeback sooner if they wish, or if side effects or warning signs occur

Appoint a return visit follow-up at the follow-up visit

• Ask the client if she is or they are still using a method or whether there have been any side effects or problems
• Refer for treatment if severe side effects are present
• Re assure the clients’ concerning minor side effects are not dangerous and suggest what can be done to relieve them