Integrating issues of sexuality into Egyptian family planning counseling

Abstract

Adequate counseling is necessary for greater acceptance and for sustained and effective family planning use. In addition to providing technical information (e.g. side-effects), family planning counseling should include issues related to gender and sexuality that can be affected by the family planning method chosen (e.g., potential changes in sexual desire due to hormonal methods). This counseling is particularly relevant for coitus-dependent barrier methods.The Population Council studied the acceptability of including sexuality issues in family planning in Egypt, a conservative society with social restrictions around discussions of sex. The study focused on the following research questions:1. Would family planning clients in Egypt accept discussing issues of sexuality during family planning counseling? 2. Would family planning providers in Egypt accept training on gender and sexuality? 3. Would training in sexuality and gender have an impact on providers' attitudes and counseling practices, and on clients' acceptance of barrier methods?The study was conducted in six family planning clinics selected from Ministry of Health and Population and Clinical Services Improvement Project clinics. Clinics were randomly assigned to three intervention and three control clinics. Physicians and nurses/counselors in all six clinics received contraceptive update training. In addition, providers in intervention clinics received three days of training on issues of gender and sexuality as they relate to family planning use.The study design included both a descriptive and a hypothesis testing component. The descriptive component examined clients' acceptance of sexuality counseling and providers' acceptance of the sexuality training. Client acceptance of discussing issues of sexuality was assessed qualitatively using focus group discussions. Client exit interviews were also conducted with family planning clients from both intervention and control clinics to gauge their satisfaction with various aspects of providers' counseling behavior. In the exit interview, clients who received sexuality counseling were asked to indicate if they were embarrassed by the discussion they had with service providers.Provider acceptance of sexuality training was assessed through observation of providers' reactions during the course, course evaluation forms, and a provider questionnaire that was completed six weeks after the training course. The hypothesis testing component used a post-test only non equivalent control group design. The impact of sexuality training on providers' attitudes towards barrier methods and sexuality counseling was measured using multi-item indices relating to the principal features of barrier methods and dimensions of the sexuality counseling. Changes in counseling practices were measured both qualitatively and quantitatively using "mystery clients" and client exit interviews. Client acceptance of barrier methods was also measured in the two groups of clinics using client exit interviews. Three levels of acceptance were distinguis...

Integration of STI and HIV Prevention, Care, and Treatment into Family Planning Services: A Review of the Literature

“…Although in theory RH providers already possess several of the technical and service skills they require to offer HIV-related information and services for transmission prevention (Askew and Berer 2003), evidence reveals the difficulties providers face in addressing STI/HIV prevention and conducting behavioral risk assessments for clients. A major barrier, documented in a variety of studies conducted in Africa, is providers' discomfort with discussing HIV-risk or sexual behavior with clients Population Council 1999;Abdel-Tawab et al 2000;Lafort et al 2003;Creanga et al 2007;Liambila et al 2008). Nevertheless, a growing body of evidence suggests a positive benefit from including sexual health counseling within RH programs and the need for intensive training and reorientation of staff to improve their skills to undertake this counseling (Abdel-Tawab et al 2000;Campbell and Lambey 2002;Helzner 2002;KIT n.d.).…”

Integrating Sexual Health Services Into Primary Care: An Overview of Health Systems Issues and Challenges in Developing Countries

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Education based on theory of planned behavior over sexual function of menopausal women in Iran

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