contraceptive counseling,
the consumer-powered way

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.  

And 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.

Our experience in our own programs has shown that women who received FP counseling from a C4C trained provider felt respected by their provider and believed that their preferences about contraception were taken seriously. We’ve also learned that person-centered approaches to FP counseling like C4C lead to better quality of care experience for the client and greater satisfaction with clients’ chosen methods.  

Informed choice is fundamental to FP service delivery. Though our work on 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, and that their provider consistently addressed their concerns.

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 experiencewith 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.

C4C is grounded in
evidence and it works

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.

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

As a result, clients counseled through C4C are more: 

  • Satisfied with their counseling experience
  • Likely to continue their voluntary FP method for as long as they need it
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. An academic paper outlining the study and its results is under review.

“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



This is the cornerstone of the C4C approach. Designed to facilitate a dialogue between provider and client, the book guides providers through C4C’s principles, job aids and frequently needed technical information to support providers to address the specific needs of each new client.

c4c trainings: core materials

Whether conducting the training in person or virtually, there are core components that every C4C training must include. We've packaged the recommended core set of modules and activities and a sample agenda to get you going. And we're available to support you to apply the C4C approach into your own FP counseling work.

Leading your own C4C training?
Get in touch

We're here to assist you! The training materials are just the start, but there are more detailed guides and information we can provide you with. Contact Alexandra Angel or Kendal Danna for details.


We're adapting the the C4C suite of tools 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.

“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.” 

— FP provider in Mali



Technical Advisor, Sexual & Reproductive Health


Technical Advisor, Sexual & Reproductive Health


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