Disclaimer, National Library of Medicine American College of Obstetricians and Gynecologists. As the U.S. health-care system evolves in response to increased efforts to expand health insurance coverage, contain costs, and emphasize preventive care (9), providers of family planning services will face new challenges and opportunities in care delivery. Bruce J. A woman is at lower risk of unintended pregnancy if she is using a highly effective method, such as an IUD or implant, or has an established history of using methods of contraception, such as injections, pills, patch, or ring correctly and consistently (38,39). For example, clients who are trying to achieve pregnancy and those at high risk of unintended pregnancy should be given higher priority for preconception health services. Starting family planning methods after childbirth. Demography 2008;45:81727. of pages found at these sites. Keywords: For clients without a primary care provider, the following screening services should be provided, with appropriate follow-up, if needed, while linking the client to a primary care provider. All MMWR HTML versions of articles are electronic conversions from typeset documents. Site has written agreements (e.g., MOUs) with the key partner agencies for health care (especially prenatal care, primary care, HIV/AIDS) and social service (domestic violence, food stamps) referrals. The care provides good return relative to the costs involved, such as a return on investment or a reduction in the per capita cost of health care.*. Once providers have determined what information is needed, the next steps are to collect and use that information to improve the quality of care. [no_toc] First level Assessment. [Originally posted on K4Healths bloghere]. Family planning is the decision-making process by couples, together or individually, on the number of children that they would like to have in their lifetime . More specifically, providing counseling to clients during family planning services was found to improve both long term outcomes, such as increased birth spacing and continued use of modern contraception methods, as well as short term outcomes such as increased knowledge and satisfaction with family planning services [ 12, 13, 14, 15 ]. Male sterilisation. Langley G, Nolan K, Nolan T, Norman C, Provost L. The Improvement Guide: A practical approach to enhancing organizational performance. American College of Obstetricians and Gynecologists. Women who are not pregnant and who are trying to become pregnant should be offered services to help achieve pregnancy or basic infertility services, as appropriate (see "Clients Who Want to Become Pregnant" and "Basic Infertility Services"). Reducing health disparities by promoting patient-centered culturally and linguistically sensitive/competent health care. Background Family planning is a key means to achieving many of the Sustainable Development Goals. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2008. Olds DL, Kitzman H, Cole R, et al. The male genital examination: a position paper of the Society for Adolescent Health and Medicine: a position paper of the Society for Adolescent Health and Medicine. Providers should follow CDC recommendations that all clients aged 1364 years be screened routinely for HIV infection and that all persons likely to be at high risk for HIV be rescreened at least annually (123). Rehm J, Shield KD, Joharchi N, Shuper PA. Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta-analysis of experimental studies. Selected practice recommendations for contraceptive use 2013. Fam Plann Perspect 2001;33:5261. Am J Obstet Gynecol 2006;194:12905. In addition, ACOG recommends that rubella titer be performed in women who are uncertain about MMR immunization (108). Elk Grove, IL: American Academy of Pediatrics; 2007. * Key principles of providing quality counseling including education have been outlined (Appendix C). Ann Intern Med 1997;127:7338. Washington, DC: American College of Obstetricians and Gynecologists; 2007. It is important to help women and their partners to gain increased control over their reproductive health. The need for cervical cytology should not delay initiation or hinder continuation of a contraceptive method (42). Title X family planning. In a family planning setting, all women planning or capable of pregnancy should be counseled about the need to take a daily supplement containing 0.4 to 0.8 mg of folic acid, in accordance with the USPSTF recommendation (Grade A) (104). A pelvic examination should assess for: pelvic or abdominal tenderness, organ enlargement or mass; vaginal or cervical abnormality, secretions, or discharge; uterine size, shape, position, and mobility; adnexal mass or tenderness; and cul-de-sac mass, tenderness, or nodularity. In some cases women may feel more comfortable if their partners are not present or if their partners are counselled on their own and/or by a male counsellor. This session only provides an introductory overview on family planning counselling. J Biosoc Sci 2010;42:30725. URL addresses listed in MMWR were current as of Lederman RP, Chan W, Roberts-Gray C. Parent-adolescent relationship education (PARE): program delivery to reduce risks for adolescent pregnancy and STDs. Knowledge, attitude and practice of family planning in Eastern Nigeria: implications, prospects and suggestions. Births: final data for 2012. This field is for validation purposes and should be left unchanged. Optimal evaluation of the infertile female. 1997 Apr;29(2):141-9. doi: 10.1017/s0021932097001417. Boston, MA: John Snow International; 2012. In the family planning setting, providers may prioritize screening and counseling about preconception health for couples that are trying to achieve pregnancy and couples seeking basic infertility services. 95% of the study participants achieved the desired outcome while following all the directions perfectly (and 5% of the study participants didn't experience the desired outcome, even though they followed the directions perfectly). Fertility rate, total (births per woman). Delaying second births among adolescent mothers: a randomized, controlled trial of a home-based mentoring program. Would you like email updates of new search results? This information should clarify that avoiding sex (i.e., abstinence) is an effective way to prevent pregnancy and STDs. The choice of using contraceptive methods helps individuals/couples reach the optimum family size and reduce unwanted pregnancies. English A. Counselling for Maternal and Newborn Health Care: A Handbook for Building Skills, Providing information that builds on existing knowledge, Facilitating shared problem-solving and decision-making. To us, this represents a change in this mans behavior that can be replicated by his children in the future. A broad range of methods, including long-acting reversible contraception (i.e., intrauterine devices [IUDs] and implants), should be discussed with all women and adolescents, if medically appropriate. Family planning is among the most cost-effective of all health interventions. A client using or considering contraceptive methods other than condoms should be advised that these methods do not protect against STDs. Conduct a physical assessment related to contraceptive use, only when warranted. Arch Pediatr Adolesc Med 2007;161:11239. Develop a plan for follow-up. Goal: Improve pregnancy planning and prevent unintended pregnancy. Site uses electronic health information technology or electronic health records to improve client reproductive health. Institute of Medicine. Family planning; Nigeria; Social and behavior change. It is achieved through the use of contraceptive methods and the treatment of involuntary infertility. Abbreviations: A = Class A: essential and mandatory in all circumstances for safe and effective use of the contraceptive method; B = Class B: contributes substantially to safe and effective use, but implementation might be considered within the public health and/or service context (the risk of not performing an examination or test should be balanced against the benefits of making the contraceptive method available); C = Class C: does not contribute substantially to safe and effective use of the contraceptive method; Cu-IUD = copper-containing intrauterine device; LNG-IUD = levonorgestrel releasing intrauterine device. If she has no post-abortion complications or infection, she can safely use any family planning method, and can start all methods immediately post-abortion (except for the natural calendar method, when she should wait for 3 months). The primary audience for this report is all current or potential providers of family planning services, including those working in service sites that are dedicated to family planning service delivery as well as private and public providers of more comprehensive primary care. Providers should screen men who have sex with men (MSM) for chlamydia at anatomic sites of exposure, in accordance with CDC's STD treatment guidelines (36). Accessibility Oringanje C, Meremikwu MM, Eko H, Esu E, Meremikwu A, Ehiri JE. If she thinks she could be at risk of getting STI/HIV, she should use a condom in all sexual relations. Am J Psychiatry 2003;160(Suppl):160. Clinical pathway of family planning services for women and men of reproductive age. Explain that she can become pregnant as soon as two weeks after an abortion if she begins to have sexual relations. Providers also may inform clients about the availability of emergency contraceptive pills and may provide clients an advance supply of emergency contraceptive pills on-site or by prescription, if requested. Amongst the participants who had used a family planning method (46.9%), less than half of them (47.9%) were currently using a type of family planning method. In other words, family planning is voluntary, and available methods of contraception (previously referred to as birth control) can be customized to individual needs with a range of methods that are acceptable to all, effective, and easy to use like Plan B. Unmet need for family planning applies only to married women and indicates those women who say they prefer to avoid a pregnancy but are not using any method of contraception. It is important to follow these guidelines both to ensure that clients receive needed services and to avoid unnecessary screening. 12, FAMILY PLANNING COUNSELLING. 1994 Jun;9(2):237-58. doi: 10.1177/026858094009002008. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2009. Does the measure produce consistent (reliable) and credible (valid) results about the quality of care? . In this report, health services are divided into three main categories: Providers of family planning services should be trained and equipped to offer all family planning and related preventive health services so that they can provide optimal care to clients, with referral for specialist care, as needed. In general, the steps or actions outlined below should be covered to counsel on family planning. Forgone health care among U.S. adolescents: associations between risk characteristics and confidentiality concern. Addiction 2012;107:519. The Lactational Amenorrhea Method (LAM): a postpartum introductory family planning method with policy and program implications. Male involvement interventions often facilitate role-play and other activities that help men practice conversations about reproductive decision-making. Available at. A life-course approach incorporating appropriate preconception and contraception care is key to achieving optimal maternal, neonatal, and child health outcomes. We look forward to welcoming Dominick Shattuck to IRH in June as a Senior Research Officer! These recommendations focus on the direct delivery of care to individual clients. US Preventive Services Task Force. This can be done through outreach work or through discussion with men when they accompany their wives or partners to the health facility. Am J Obstet Gynecol 2008;6:S38995. A description of how the recommendations link to the evidence is provided together with the rationale for the inclusion of each recommendation in this report (Appendix B). You could also ask her to demonstrate the use of certain methods such as condoms or diaphragms, or you could consider demonstrating their use to her first, asking for her to repeat back the demonstration afterwards to ensure that she has fully understood. Olds DL, Kitzman H, Hanks C, et al. Sexually transmitted diseases treatment guidelines, 2010. Overview. American Academy of Pediatrics. A negative pregnancy test also provides an opportunity to discuss the value of making a reproductive life plan. Objective . J Adolesc Health 2007;41:33342. For all clients, providers should screen adult (Grade B) and adolescent (Grade B) clients for obesity in accordance with the USPSTF recommendation, and obese adults should be referred for intensive counseling and behavioral interventions to promote sustained weight loss (118,119). | Explore the latest full-text research PDFs . If a client does not have another source of primary care, priority should be given to providing related reproductive health services or providing referrals, as needed. When discussing her needs and situation, you can ask about: whether she and/or her partner want to use family planning; previous methods used and reasons for success or failure; popular beliefs about family planning and how these affect her decision to choose a particular method; her relationship and situation; Is she in a stable relationship? All sexually active adolescents are at risk, and adults are at increased risk if they have current STDs, had an STD in the past year, have multiple sexual partners, are in nonmonogamous relationships, or are sexually active and live in a community with a high rate of STDs. If a woman, preferably with her partner, is able to make an informed choice, she is more likely to be satisfied with the method chosen and continue its use. When they have to go to school, he combs their hair, packs their lunches, and organizes their school bags.. The following questions should be considered when selecting performance measures (143): Performance measures should consider the quality of the structure of services (e.g., the characteristics of the settings in which providers deliver health care, including material resources, human resources, and organizational structure), the process by which care is provided (whether services are provided correctly and completely, and how clients perceive the care they receive), and the outcomes of that care (e.g., client behaviors or health conditions that result) (149). MMWR 2013;62(Suppl 1):119, http://www.uspreventiveservicestaskforce.org/uspstf/uspsaddepr.htm, http://www.uspreventiveservicestaskforce.org/uspstf/uspschdepr.htm, http://www.uspreventiveservicestaskforce.org/uspstf/uspschobes.htm, http://www.uspreventiveservicestaskforce.org/uspstf11/obeseadult/obesers.htm, http://www.uspreventiveservicestaskforce.org/uspstf/uspshype.htm, http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm, CDC. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2012. Family planning services include the following: This report provides recommendations developed collaboratively by CDC and the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS). Components of this examination include inspecting skin and hair, palpating inguinal nodes, scrotal contents and penis, and inspecting the perinanal region (as indicated). Winner B, Peipert J, Zhao Q, et al. Stud Fam Plann 1990;21:6191. Roser, M. and H. Ritchie. These key steps are in accordance with the five principles of quality counseling (Appendix C). Contraception 2013;87:15461. Obtain clinical and social information from the client. A.K. Providers should provide cervical cancer screening to clients receiving related preventive health services. If the woman wants female sterilization or an Intrauterine Device (IUD) inserted immediately after childbirth, she should inform her birth attendant and plan to give birth in a health facility. (SAQs 1.2 and 1.5) . J Perinat Neonatal Nurs 2004;18:213. Pediatrics 2008;121:1263. Contraceptive counseling is defined as a process that enables clients to make and follow through on decisions about their contraceptive use. telephone: (202) 512-1800. Available at http://www.cdc.gov/std/treatment. STD treatment guidelines. Providing men and women the opportunity to engage in family planning discussions as part of maternity caretogether or separatelycan directly address these inequitable norms and create space for joint decision-making for effective use of family planning. Washington, DC: National Academies of Science; 2001. If needed, the client also should be vaccinated for hepatitis B and HPV (113). TABLE 4. Indicates that screening is suggested only for those persons at highest risk or for a specific subpopulation with high prevalence of infection or other condition. However, measuring weight and calculating BMI at baseline might be helpful for monitoring any changes and counseling women who might be concerned about weight change perceived to be associated with their contraceptive method. Is there a consistent pattern of performance among providers? For male clients, providers should screen MSM for gonorrhea at anatomic sites of exposure, in accordance with CDC's STD treatment guidelines (36). Target 3.7: By 2030, ensure universal access to sexual and reproductive health care . Tailoring to specific family planning needs. Does it provide protection from STIs or HIV? In order to help counsel a woman on family planning, it is very important to discuss her and her partner's specific needs and situation. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Zavodny M. Fertility and parental consent for minors to receive contraceptives. We define the goals of male involvement interventions as: The interventions are often labeled male involvement, but they can have other names as well and encompass a variety of activities. Summary List of Indicators 5 Number/percentage of trainees competent to provide a specific family planning service Number/percentage of trained providers assessed to be competent at a specific period (e.g., 6 months) post-training Number/percentage of trainees who apply the skills to their subsequent work C. Commodities and Logistics Pipeline wastage Social and behavior change (SBC) programs often try to shift drivers of high fertility through multiple channels including mass and social media, as well as community-level group, and interpersonal activities. Skilled counsellors facilitate the process while taking a back seat when it comes to making a decision. Northwestern Nigeria faces a situation of high fertility and low contraceptive use, driven in large part by high-fertility norms, pro-natal cultural and religious beliefs, misconceptions about contraceptive methods, and gender inequalities. Contraception 2011;84:47885. Am J Obstet Gynecol 2008;199[6 Suppl 2]:S38995). In a given year, approximately 20% of adolescent births represent repeat births (88), so in addition to providing postpartum contraception, providers should refer pregnant and parenting adolescents to home visiting and other programs that have been demonstrated to provide needed support and reduce rates of repeat teen pregnancy (8994). Some women who have recently given birth or who are breastfeeding may be unable to use certain methods (see. MMWR 2010;59[No. Adolescents who come to the service site alone should be encouraged to talk to their parents or guardians. Preconception health-care services for women aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcomes through prevention and management. Data for this study come from a cross-sectional household survey, conducted in the states of Kebbi, Sokoto and Zamfara in northwestern Nigeria in September 2019, involving 3000 women aged 15 to 49 years with a child under 2 years. In certain cases, when the evidence from the literature reviews was inconclusive or incomplete, recommendations were made on the basis of expert opinion. 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