Printable Version

JHU/CCP

Contents

• Editors' Summary
• Credits

1. Why Informed Choice Matters
2. Making Family Planing Decisions
3. Policies for Informed Choice
4. Communication for Choice
5. Improving Access
6. Managing for Informed Choice
7. Client-Provider Communication

• Figures
• Table
• Side-bars
• Bibliography

• What can be done?
• Women know what they want
• Why communities matter
• Eliminating targets
• More methods, more choices
• "Your health is in your hands"
• Do clients have choices?
• Please Ask!
• How much guidance?
• Active clients, better choices
• Counseling continuing clients

• POPLINE
• Media/Materials Clearinghouse
• Other Issues
• To order copies
• CCP Home Page

Published by the Population Information Porgram, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA.

Informed Choice in Family Planning

Helping People Decide

The best decisions about family planning are those that people make for themselves, based on accurate information and a range of contraceptive options. People who make informed choices are better able to use family planning safely and effectively. Providers and programs have a responsibility to help people make informed family planning choices.

Decisions about childbearing and contraceptive use are most likely to meet a person's needs when they reflect individual desires and values, are based on accurate, relevant information, and are medically appropriate—that is, when they are informed choices. To make informed choices, people need to know about family planning, to have access to a range of methods, and to have support for individual choice from social policies and community norms.

Informed choice offers many benefits. People use family planning longer if they choose methods for themselves. Also, access to a range of methods makes it easier for people to choose a method they like and to switch methods when they want. People's ability to make informed choices invites a trusting partnership between clients and providers and encourages people to take more responsibility for their own health. Enabling clients to make informed choices is a key to good-quality family planning services.

The principle of informed choice refers to decisions that people can make for themselves—not to a process that family planning programs and providers carry out. Nevertheless, programs, providers, and policy-makers can do much to support people's ability to make informed family planning choices. Programs can do so best by adopting a strategy that covers five areas—government policies, communication programs, access to family planning, leadership and management, and client-provider communication.

Supportive policies. To support people's ability to make informed family planning choices, national governments and family planning programs can set standards and guidelines for service delivery; eliminate unnecessary medical barriers and all demographic targets, incentives, and disincentives; and ensure that people can have access to the methods they prefer. National social and economic policies, too, can improve people's ability to make informed choices for themselves, as when they improve women's education and social status.

Communication programs. Communication programs can reach and inform the public about their family planning choices. In the mass media and through community social networks, communication can convey that people have a right to information about their own health and that they can make good family planning decisions for themselves, based on their own needs and desires. Messages can emphasize contraceptive methods that are available and tell where and how to find information and services. Communication programs also can encourage people to visit family planning providers for answers to their questions and concerns.

More access. The more family planning methods that are available, the more people can choose a suitable method and the better they can switch methods as their needs change. Offering a variety of methods through as many service delivery outlets as possible helps to ensure choices for everyone, including people living in rural areas, those with low incomes, those who cannot easily leave home, and those who do not want to visit clinics.

Leadership and management. Strong leadership can establish the principle of informed choice as a program goal and a measure of success. Program managers can make informed choice the organizational norm by analyzing and improving performance, providing effective supervision, training staff members, and evaluating results. Managing for informed choice requires particular attention to decisions about permanent and long-term methods—sterilization, IUDs, and implants—because these decisions are not easily reversed once they have been made.

Client-provider communication. People can make informed choices without ever seeing a family planning provider. When people visit providers, however, there is much that providers can do to ensure informed choice. Providers can ask new clients what method they prefer and usually can give them that method. They can ask continuing clients whether they would like to switch methods. They can avoid making decisions for clients or interfering with their ability to make choices. In effective counseling for informed choice, clients play an active role, asking questions, expressing concerns, and participating equally with providers.

Decisions about reproductive health and contraceptive use are among the most crucial that people of childbearing age make. With widespread endorsement of informed choice in family planning, people around the world can have better information, a wider range of choices, and more support for making appropriate decisions themselves. Ensuring informed choice in family planning should be the goal of donor agencies, governments, family planning programs, and providers everywhere.