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The balanced counseling strategy plus : a toolkit for family planning service providers working in high HIV/STI prevalence settings

POPULATION COUNCIL
2011

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"This "is an interactive, client-friendly approach for improving counseling on family planning and prevention, detection, and treatment of sexually transmitted infections (STIs) including HIV. The BCS+ was adapted from the Balanced Counseling Strategy, an evidence-based and well-researched tool for improving counseling on contraceptive methods. The BCS+ toolkit, developed and tested in Kenya and South Africa, provides the information and materials needed for health care facility providers to provide complete and high-quality family planning counseling to clients who live in areas with high rates of HIV and STIs.The BCS+ tools are generic and can be revised according to national and/or regional guidelines and different contexts
This second edition toolkit includes the following: * BCS+ Trainer’s Guide: Supervisors and others can use this to train health care facility directors and service providers on how to use the BCS+ for counseling family planning clients. * BCS+ User’s Guide: This guide focuses on how to implement the Balanced Counseling Strategy Plus. It can be distributed during training or used on its own with the BCS+ job aids. * BCS+ job aids comprising: - BCS+ algorithm that summarizes the 19 steps needed to implement the BCS+ during a family planning counseling session. These steps are organized into four stages: pre-choice, method choice, post-choice, and STI/HIV counseling. - BCS+ counseling cards that the provider uses during a counseling session. There are 26 counseling cards, the first of which contains six questions that the service provider asks to rule out the possibility a client is pregnant. Each of the next 16 cards contains information about a different family planning method. The next 3 cards provide advice on pregnancy and the postpartum period. The last 6 cards provide essential information for counseling on preventing, detecting, and treating STIs and HIV. - BCS+ method brochures on each of the 16 methods represented by the counseling cards. The brochures provide counseling to clients on the method they have chosen and then are given to clients for later reference. This means clients do not have to rely on their recollection of what was discussed with the provider. - WHO Medical Eligibility Criteria Wheel (offsite link) guides providers through medical conditions and medications that may be contraindications to use of particular contraceptive methods. The BCS+ tools are generic and can be revised according to national and/or regional guidelines and different contexts"
A video describing use of the BCS+ toolkit in South Africa also is available. To obtain Microsoft Word versions of BCS+ files to modify or revise according to your local setting, please contact the publisher

The effect of family size and composition on fertility desires, contraceptive adoption, and method choice in South Asia

JAYARAMAN, Anuja
MISHRA, Vinod
ARNOLD, Fred
March 2008

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This research looks at the influence of family size and composition on reproductive behaviour in three South Asian countries - Nepal, India, and Bangladesh - that are known for strong son preference. Data from recent Demographic and Health Surveys, was analysed to see whether the choice of contraceptive method adopted (modern versus traditional; temporary versus permanent) and desire for another child differed by parity and sex composition of surviving children

The potential impact of community-based distribution programmes on contraceptive uptake in resource-poor settings : evidence from Ethiopia

TAWYE, Yenehun
et al
December 2005

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This article assesses the impact of community-based reproductive health services (CBRHS) and programmes on contraceptive use in Ethiopia. The 1993 National Population Policy provided a strong political backing to community-based contraceptive programmes, which grew in number and outreach to the community. The article shows that 'women living in areas covered by the CBRHS programme were three times more likely to use contraception than the average Ethiopian woman'. The study concludes that scaling up the programme nationwide would have the effect of doubling the national contraceptive prevalence rate

Trends in the timing of first marriage among men and women in the developing world

MENSCH, Barbara S
SINGH, Susheela
CASTERLINE, John B
August 2005

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The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in the timing of first marriage or union for men and women in the developing world. With the exception of South America for both sexes and South and Southeast Asia for men, substantial declines have occurred in the proportion of young men and women who are married. Given the differentials in the timing of marriage by educational attainment and residence, we assess whether the decline in the proportion of young people who are married is related to increases in schooling and urbanization. Expansion of schooling for women has had some impact, but a considerable portion of the reduction in early marriage is not explained by changes in levels of education. We consider other factors that might account for the increase in age at marriage. Finally, we review what is known about the consequences of changing age at marriage with a particular focus on risk of HIV infection.

Educate clients to communicate their needs to providers

POPULATION COUNCIL, Frontiers in Reproductive Health
January 2004

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This is a brief summary of the findings from the 'Smart Patient' intervention coordinated by Indonesia's National Family Planning Coordinating Board (BKKBN) and Johns Hopkins University, with support from Frontiers. Family planning clients were given a brief training session to improve their communication skills before seeing a service provider. The findings show that women agreed that coaching helped them to gain confidence, ask more questions and express their concerns. Providers were more likely to tailor information to individual needs. Eight months following the intervention, clients were more likely to continue to use a contraceptive method

Increasing client participation in family planning consultations : 'smart patient' coaching in Indonesia

MI KI, Young
et al
2003

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This is a report of the study 'Operations research: impact of client communication training on client participation and contraceptive continuation in Indonesia'. Family planning clients were given a brief training session to improve their communication skills before seeing a service provider. The findings show that women agreed that coaching helped them to gain confidence, ask more questions and express their concerns. Providers were more likely to tailor information to individual needs. Eight months following the intervention, clients were more likely to continue to use a contraceptive method

The female condom : dynamics of use in urban Zimbabwe

KERRIGAN, Deanna
et al
October 2000

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This is the report of a study to increase public understanding of the patterns and dynamics of female condom use in Zimbabwe in order to help the country's policymakers and programme planners make decisions about promotion and distribution of the female condom

Mainstreaming quality improvement in family planning and reproductive health services delivery : context and case studies

JOHN SNOW INC
January 2000

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This document summarizes SEATS' experience in improving the quality of family planning and reproductive health services in a wide variety of settings. It outlines how SEATS approached "mainstreaming" continuous quality improvement in its subprojects, with special emphasis on making services more responsive to clients' concerns. It shows how the project's approach to improving and measuring the quality of care evolved and suggests how to build on the project's experience. The report includes brief case studies from Albania, Cambodia, Eritrea, Russia, Senegal, Turkey, Zambia and Zimbabwe, and describes how the program improved the quality of care in hospitals, public and private clinics, community-based distribution programs, and private midwifery practices. This report is intended for program managers at the systems level, such as those involved with national, regional, or municipal activities, or in institutions such as NGOs or hospitals

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