Length of Counseling Sessions and the Amount of Relevant Information Exchanged: A Study in Peruvian Clinics

Abstract

International Family Planning Perspectives in Ecuador, Uganda and Zimbabwe, fewer than 75% of clients in each country were given any information about the contraceptive method they re c e i v e d . 5 Results are no diff e rent when the specific content of counseling is examined. For example, to probe how well clients w e re being counseled about when and how to switch methods, a study carried out in the coastal province of Santa, Peru , used simulated clients who had recently initiated pill use and who complained of headaches. Of the 54 Ministry of Health p roviders who were approached, more than 25% failed to tell the client that the headaches might be a side effect of pill use, and more than 30% did not tell her that they might disappear shortly. 6 In a similar study based on a national sample of 25 hospitals and 74 clinics in Ecuador, 47% of providers failed to tell the client that her headaches might be a side effect of the pill, and 61% neglected to inform her that they might go away with time. 7 When confronted with such evidence of incomplete counseling, providers generally attribute their shortcomings to causes beyond their control. In rural areas of Federico R. León is program associate with the Fro n t i e r s in Reproductive Health program of the Population Council, Lima, Peru. At the time this re s e a rch was conducted, Rosa Monge was a consultant, Adriana Zumarán was an intern, Ingeborg García was an intern and Alex Ríos was a re s e a rch assistant, all at the Population Council, Lima. The authors thank Lucy López for her comments on the study tools, Jorge Parra for his help in facilitating access to the health centers and John Townsend and Cynthia G reen for their useful comments on earlier drafts of this article. The re s e a rch upon which this article was based was made possible by funding from the U.S. Agency for International Development (USAID) under cooperative a g reement HRN-A-00-98-0012-00 with the Population Council. The opinions expressed herein are those of the authors and do not necessarily re flect the view of USAID. Length of Counseling Sessions and the Amount Of Relevant Information Exchanged: A Study in Peruvian ClinicsBy Federico R. León, Rosa Monge, Adriana Zumarán, Ingeborg García and Alex Ríos T he concept of "informed choice" in family planning counseling implies that providers assist clients in selecting the method that best satisfies their needs, and that clients leave the session knowing about the side effects of their chosen method and how to use it safely and eff e c t i v e l y. 1 Worldwide, however observational findings suggest that actual counseling is far from meeting these requirements.Audiotaped counseling sessions in Kenya, for example, revealed that only 57% of clients receiving the injectable and 32% of those getting the pill were provided with information on their method's side eff e c t s . 2 A situation analysis of Nairobi clinics showed that fewer than 50% of new clients w e re provided with information on contraindications to or side effects of thei...

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