Family Planning Counseling

Family Planning Counseling

Family Planning Counseling

Family Planning Counseling is a continuous process that you as health care provider, as a counselor provide to help clients and people in the community or health facility make and arrive at informed choices about the size of their family (i.e. the number of children they wish to have)

Counseling is a face to face communication that you have with your client or couple in order to help them arrive at involuntary and informed decisions.

Informed choice is defined as involuntary choice or decision based on the knowledge relevant to the choice or decision.

In order to allow people to make an informed choice about family planning, you must make them aware of all available methods and advantages and disadvantages plus side effects of each .

They should know how to use the chosen method safely and effectively as well as understanding possible side effects.

Aims of Counseling 

  • The primary objective of counseling in the context of family planning is to help people decide the number of children they wish to have and when to have them.
  • To help clients choose voluntarily, the method that is personally and medically appropriate to them.
  • To ensure they understand how to use their chosen method correctly for safe and effective contraceptive protection  
  • To clear rumors and misconceptions a client may have about family planning methods

Types of Family Planning Counseling.

There  are varieties of approaches for different types of family planning counseling:

  • Individual counseling 
  • Couple counseling 
  • Group counseling and information sharing
Individual counseling 

This is a counseling approach that involves only one client. it involves individual privacy and confidentiality during communication or counseling with you.

It is mostly important when dealing with confidential matters that relate to family planning and other reproductive health issues . HIV couples, the woman wants to use family planning but the husband does not.


Couple counseling 

Couples counseling refers to counseling sessions in which a woman and her partner are present in discussions with the provider. 

However, it must be recognized that couples counseling requires special sensitivity and skills to deal with gender related issues.


Group counseling and information sharing

This is counseling approach involving a group of many people.

It is used when individual counseling is not possible or there are people in the village who are more comfortable in a group.

It is a cost effective of information sharing and answering general questions but people are not likely to share their more personal concerns with you in this situation.

General principles of counseling

  • Privacy-find a quiet place to talk
  • Take sufficient time
  • Maintain confidentiality
  • Conduct a discussion in a helpful atmosphere
  • Keep it simple-use words people in your village will understand
  • First things first –do not cause confusion by giving too much information 
  • Say if again –repeat the most important instructions
  • Use available visual aids like posters and flip charts etc.

Characteristics of a good counselor

The most important characteristics of a good counselor are:

  • Respect the dignity of others
  • Respect the clients’ concerns and ideas
  • Be non-judgmental and open 
  • Show that you are being an active listener
  • Be empathetic and caring
  • Be honest and sensitive

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.


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


  • 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 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 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 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 

Rights of the client

  1. Information : to learn about their reproductive health ,contraception and abortion options
  2. Access : to obtain services regardless of religion, ethnicity, age, marital or economical status 
  3. Choice : to decide freely whether to use contraception and which method
  4. Safety : to have a safe abortion and to practice safe, effective contraception
  5. Privacy : to have a private environment during counseling process
  6. Confidentiality : to be assured that any personal information will remain confidential
  7. Dignity : to be treated with courtesy ,consideration and effectiveness 
  8. Comfort : to feel comfortable when receiving services 
  9. Continuity : to receive follow-up care and contraceptive services and supplies for as long as needed
  10. Opinion : to express views on the service offered. 

Factors influencing family planning counseling outcomes

Factor related to the health care provider

  • Effective communication
  • Technical knowledge and skills, attitudes and behaviors can influence in effectiveness of counseling process

Factors related to the client

  • Client’s level of knowledge and understanding, what they choose to do may also be affected by the extent to which they trust and respect a service provider.
  • Personnel situation (e.g. .if the spouse or another family member has a difference to them)
  • External programmatic factors
  • In most health facilities the space or rooms for provision of family planning is integrated with other reproductive health services .This can make it very difficult for you to find a place where privacy and confidentiality can be maintained .
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