Percent of clients who receive high quality, comprehensive counseling for LAPMs
Percent of clients in facilities that provide at least one long-acting or permanent method (LAPM) and/or offer referrals for LAPMs who received high quality counseling for LAPMs for example:
- Greet client respectfully according to local norms
- Maintain auditory and visual privacy
- Give sufficient key information to clients about requested services
- Allow client to talk and listens to client’s concern, responds to questions, and assesses need for other services
- Use service-specific job aids and behavior change communication (BCC) materials during counseling
- Use Tiahrt chart as a BCC material
- Ensure customer’s eligibility, ensures voluntarism and informed choice, and gets informed consent
This indicator is calculated as:
(Number of observed LAPM counseling sessions that were deemed high quality and comprehensive / Total number of observed LAPM counseling sessions) x 100
Data compiled from use of a checklist of quality components in a LAPM counseling session collected by trained observers who attend counseling sessions. See the Sample Medical Monitoring Checklists by the ACQUIRE Project/EngenderHealth, examples.
Data should reflect the sex, age and parity of individuals being counseled as well as the sex and age of the provider to support improved counseling skills in cases of provider bias.
If targeting and/or linking to inequity, classify outlets where counseling is taking place by location (poor/not poor) and disaggregate by area served. Exit interviews can be conducted with clients to determine client’s poverty status.
Facility observation visits or exit interviews
This measurement of quality determines the extent to which staff in facilities that provide LAPMs or referrals are providing clients with thorough and accurate information about their family planning choices. It can also be a proxy indicator for how well service providers have mastered relevant knowledge from an LAPM training. If the evaluator observes the counseling session to be insufficient, the data should be used in a positive, not punitive way to support enhanced counseling skills.
Evaluators should take into consideration the context in which the observed counseling session is taking place. For example, there may be contextual factors such as the counseling area lacks privacy or there is a long line of clients to be seen that may compromise the quality of counseling services, even if the provider is fully competent to provide high-quality, comprehensive LAPM counseling.
family planning, long-acting/permanent methods (LAPM), quality
Observers should note provider bias related to male or female methods and/or if providers counsel women, men or couples differently. A gender assessment of counseling could highlight if programs need to find better ways to engage men or better ways to understand the constraints women experience in accessing the full range of contraceptive methods.