OUR Person-Centered Approach to
Contraceptive Counseling

Counseling for Choice (C4C) is an evidence-based approach to contraceptive counseling that supports clients to decide which method is right for them. By addressing many of the root causes of unmet need for contraception and discontinuation, C4C aims to change how providers and clients participate in voluntary family planning (FP) counseling discussions.  The approach comprises a thorough training in C4C techniques and the use of the Choice Book for Providers, a job aid and visual tool providers use with clients during counseling sessions.   

We’ve made the C4C tools and approach available as a global good, for use by implementers like you. 


Clients are the experts on their own lives, and their needs and preferences should be the foundation of their healthcare decisions. The evidence for C4C and our experience across our own programs has shown that women who receive FP counseling from a C4C trained provider feel more respected by their provider and believe that their preferences about contraception are taken seriously. We’ve also learned that C4C leads to a better quality of care experience for the client and improvements across multiple indicators of person-centered care.

Informed choice is fundamental to FP service delivery, but clients need information conveyed to them in a way that is appropriate and relevant to them. Through our evaluations of C4C, PSI has learned that clients counseled using the C4C approach feel that they have the information they need and the ability to use their voice and choice to make the best decision for them. Clients counseled with the C4C approach also consistently report that C4C providers address their concerns about contraception and help them feel confident about their decisions. 

C4C employs the concept of shared decision-making in its counseling approach. In more traditional forms of FP counseling, sessions can often appear one-sided, dominated by the provider’s voice and filled with an overload of information. The C4C approach trains providers to solicit important input from the client on information that they are uniquely placed to provide: their past experiences with FP, information about their lifestyles, and which contraceptive’s benefits are most attractive to them. Evidence highlights that by using the C4C approach, clients report feeling more respected and report a better overall counseling experience.

C4C was designed to improve the counseling experience and to better support clients to choose the method that is right for them. When clients are in control of their contraceptive decisions, they can choose methods that suit their lifestyle, leaving them satisfied with their choice and content to continue using their method for as long as they are in need.


In our decades long experience with counseling, PSI recognized a persistent lack of evidence to back up the packages, approaches, and tools often used to train providers on contraceptive counseling. C4C aims to address this gap. Developed collaboratively, C4C pulls from best practices that other methods and approaches have to offer and incorporates PSI’s commitment to placing clients at the center of our work. The suite of C4C resources – tested and refined at the country-level – equip providers with the training and tools to apply the C4C approach. As a result, clients report a better counseling experience that is more Person Centered and tailored to their individual needs. 

We’ve seen that providers trained in the C4C approach are better equipped to:

  • Provide quality counseling experiences 
  • Listen to and respond to client priorities 
  • Treat clients with dignity and respect


With support from USAID, PSI’s Support for International Family Planning Organization-2 (SIFPO2) project partnered with PSI Malawi to conduct a randomized control trial of the C4C approach to determine its effectiveness meeting clients’ needs. Across several measures of quality counseling, including many validated measures of Person-Centered Care, women counseled by providers trained in the C4C approach reported better counseling experiences and a higher quality of care overall.

You can read about our findings, now published in Global Health Science and Practice, in the resource section below.

“C4C allows me to provide clients with the information that is essential for them. The approach saves me - and them - time. ”

— FP provider in Mali

more TOOLS

April 26, 2023


April 18, 2023

Evaluating Counseling for Choice in Malawi: A Client-Centered Approach to Contraceptive Counseling

Stay Tuned
there’s more to come

PSI continues to build out the C4C suite of tools, adapting the approach for use by other cadres of healthcare workers, including community health workers, pharmacists, and drug store operators. We’re also working on a client-facing, digital C4C product. These tools will also be evaluated and subsequently made available to the community of practice.

The core training materials are your start, but there are more detailed guides and information we’re happy to provide you with. If you want to use the core materials to conduct your own training in the C4C approach, reach out to us at the contact information below.


Technical Advisor, Sexual & Reproductive Health


Technical Advisor, Sexual & Reproductive Health

"C4C makes providers' jobs easier. It helps them to support clients to know her chosen method well. And clients say that they have more quality experiences with providers trained in C4C."



Discover What is Happening with Counseling
for Choice (C4C)

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