Client-Centered Family Planning Care
Client-centered family planning care enables clients to find suitable contraceptive methods, to continue using their chosen methods, and to return when they need help or another method.
Client-centered care means that clients’ needs guide the planning and implementation of family planning services. It also means that services meet medical standards, which requires providers’ commitment and expertise.
Understanding the needs, attitudes, and cultures of family planning clients enables family planning providers to offer better quality services. Good client-provider interaction is key to successful family planning programming. Thorough, high-quality screening and counseling practices enable family planning clients to make informed decisions based on their reproductive goals, individual circumstances, and lifestyles.
Programs, providers, and clients all play roles in achieving client-centered care.
- Programs put physical, administrative, and operational systems in place to ensure good-quality services. Policies and service delivery guidelines ensure safety and maximize access. Facilities are clean, well-staffed, and well-organized, with clinic hours and waiting times that are convenient for clients. Clients’ opinions about the organization and quality of services can gauge achievements and suggest improvements.
- Providers tailor family planning sessions to a client’s individual needs. They are competent, friendly, respectful, and empathic regardless of a client’s age, marital status, or socioeconomic group. They actively listen to clients and encourage them to ask questions, while ensuring privacy and confidentiality. Most importantly, they enable clients to make their own well-informed decisions—for example, helping them to consider how different contraceptive methods might fit their reproductive goals, individual circumstances, and lifestyles.
- Clients understand that their own preferences and needs guide their decision-making. With the help of programs’ communication activities, they are well-informed about method choices, side effects, and how to use their method. Clients participate actively in counseling by asking questions, expressing concerns, and disclosing appropriate information. Clients should always make their own decisions, with providers’ help, about whether to practice family planning and which method to use.
Family planning clients generally fall into four groups, each with its own needs.
- New clients who know what they want. Many new clients already have a family planning method in mind. For these clients, there is no need for providers to provide details about all available contraceptive methods. Rather, providers should determine if the client understands the method correctly and whether the client has any medical conditions that would make their preferred method unsafe. (Download the Application for Contraceptive Eligibility (ACE) mobile app to your Android phone to check medical eligibility for contraceptive methods of your clients.) If the client can safely use the method, providers should discuss with the client how to use the method correctly and consistently.
- New clients who need help choosing a method. Counseling sessions for these clients should focus on their reproductive intentions and the characteristics they are looking for in a method.
- Satisfied users who return for supplies or routine follow-up. In most programs the majority of clients fall into this category. They should receive the service or supplies that they came for without unnecessary delays and a brief offer of any other help they might want.
- Clients who return with problems or concerns. These clients should be given careful attention and counseling. If problems cannot be overcome, providers should offer to help clients choose another contraceptive method.
Some clients, such as unmarried couples, young people, and men may need special attention.
- Young people. First-time users of family planning and users under age 24 often have the highest rates of discontinuation. Messages to young people can emphasize that services are youth-friendly and ensure confidentiality. One tool, the Clinic Assessment for Youth Friendly Services, can help program managers and providers tailor services to meet the needs and preferences of young people.
- Men. Involving men in family planning is particularly important. Men are often the primary decision-makers in the family when it comes to health and fertility. Addressing men’s interests and concerns helps couples reach healthy decisions jointly and removes a common barrier to women’s use of family planning.
Job aids help providers achieve client-centered care. Some job aids purposefully take a client-centered approach
- The WHO’s Decision-Making Tool for Family Planning Clients and Providers tailors counseling sessions to help clients make informed choices and learn to use their method correctly.
- The Population Council’s Balanced Counseling Strategy helps providers structure counseling sessions to focus on the client’s needs, support the client’s choice, and improve information provided on the method.
- Family Planning: A Global Handbook for Providers offers providers the latest guidance on providing contraceptive methods including WHO’s Medical Eligibility Criteria for Contraceptive Use. (Click on the Table of Contents button on the far right in the green bar to find links to Job Aids & Tools which includes comparisons of various contraceptive methods.)