Counseling For Choice: What You Should Know About Personalizing Contraceptive Care 

By Kendal Danna, Technical Advisor, SRH, PSI

Reproductive healthcare is anything but one size fits all. However, counseling for contraceptive care can often be quick to place clients and their specific needs into pre-defined boxes. Resource constraints at the facility or provider level, prevailing myths and misconceptions about contraceptive methods, and even provider bias for certain methods can lead contraceptive counseling to ignore a person’s unique needs, preferences, and concerns. This approach disregards the key challenges that people face in their contraceptive use journeys. It can set clients up to fail by not giving them the tailored information they need — in the way that they need it — to make an informed decision about which method is right for them.

Counseling for Choice (C4C) is PSI’s person-centered approach to contraceptive counseling. Lessons learned through decades of experience working with reproductive health providers and their clients showed a critical gap in the way contraceptive counseling is traditionally done. Providers needed evidence-based tools, techniques, and training to fundamentally change their interactions with clients. The result is an environment that fosters respect for clients’ voices and decision-making power and where providers build trust and empathy with their clients through shared dialogue about what matters most to them.

The C4C approach recognizes that the benefits of a contraceptive method that providers and program implementers often attribute the most value to — effectiveness or duration of use — may not be what is most important to clients themselves. Other benefits — such as on-demand use, limited side effects, a self-administration option, or immediate return to fertility — may be the benefit that leads to client uptake and satisfaction. Through this person-centered lens, providers can facilitate a shared decision-making process that addresses each client’s needs.

As PSI continues to make the C4C approach more widely available across the community of practice, here are four things you should know:


      1. The development of the C4C approach was grounded in evidence about what works to improve the quality of contraceptive counseling — and we’re making sure our approach makes the grade. PSI evaluated the C4C approach in Malawi with funding from USAID. The results – explored in Global Health Science and Practice – speak for themselves. Across all validated measures of person-centered care, providers trained in the C4C approach offered their clients a better counseling experience, where they felt more respected and better informed. 
      2. C4C addresses three critical domains of high-quality counseling: information exchange, client-provider interaction, and anticipatory side effects counseling. The evaluation shows that clients counseled with C4C were more likely to report that they had the information they needed to make an informed decision, including the side effects they could expect. Also, they felt respected and listened to by their provider and informed about contraceptive options and correct method use. Ultimately, they felt confident in their decisions. 
      3. The foundational tool of the approach, the Choice Book for Providers, is an all-in-one tool designed to make it easier for providers to do their job effectively. But C4C is more than just its tools; it’s a philosophy. We believe that clients deserve to be treated as individuals. C4C training encourages providers to talk to clients about their lifestyle, goals, fears, and desires – to assist them in making the best contraceptive choice for them.  
      4. We believe C4C should be the approach in all contraceptive counseling, so we have made our resources available to you! C4C resources, including the 7-module C4C basic training course materials (available in English and French), are available on the C4C website here

     If you’d like to discuss how to start using the approach, contact Kendal Danna ([email protected]) to learn more.

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