This two-week forum
provided up-to-date and state-of-the-art information on what is
happening in the field and an opportunity for synergy between sharing
global best practices and country-based experiences. This forum
immediately followed a multi-country videoconference of the same title.
Discussion
Statistics
Number of participants: 394
Number of participants' countries: 61
Number of contributions: 22
% of contributions from developing countries: 32%
Number of countries contributing: 7
Contributing countries: Israel, Ethiopia, Ghana, Zambia, Sierra Leone,
USA, Bolivia)
Purpose and Objectives
Two participants posted contributions today. One participant from
Zambia described a program called "Circle of Friends" where satisfied
family planning users are able to recruit non-contraceptive users and
introduce them to a family planning provider who would counsel them and
provide a method. Another participant from Sierra Leone described
common misconceptions about contraceptive methods including the
intrauterine device (IUD) and condoms and posed a question to the
experts.
Day 1. Summarizing the videoconference
presentations
We begin the discussion by summarizing the three presentations from the
March 1, 2007 videoconference on the same topic. The presentation
titles follow:
- Contraceptive Needs and Preferences of PMTCT Clients in
South Africa, Dr. Jennifer Moodley, Women's Health Research Unit,
School of Public Health and Family Medicine, University of Cape Town
- Integration Prevention, Counseling and Testing for HIV into
Family Planning Services in South Africa, Dr. Saiqa Mullick, Population
Council (Frontiers)
- Integration of RH/FP and HIV/AIDS Activities: Experience of
Pathfinder International from Implementing Best Practices (IBP) and
Other Initiatives, Dr. Mengistu Asnake, Pathfinder International
- Jennifer Moodley mentioned in her presentation at the
videoconference that the HIV+ women they observed in South Africa
seemed to have misconceptions about the safety of some contraceptive
methods. In your own experience, do women in your country have similar
fears and misconceptions about the safety of some methods? If so, which
methods? What are their fears? How have you or other providers tried to
change their misconceptions?
- Saiqa Mullick described a "Balanced Counseling Strategy”
(BCS) approach to family planning in her presentation at the
videoconference. In this strategy, the client is given information
about a range of family planning methods available and the provider
helps the client make a choice from appropriate contraceptive methods.
The provider is trained to use an algorithm to help narrow down the
choices and is equipped with job aids and communication materials to
share with the client. At the same time, providers are trained to
stress the importance of condom use for dual protection. In your own
experience, how often do providers spend time helping clients decide on
which family planning method is best for them? What is the best way to
explain dual protection to clients who have selected other family
planning methods?
- Dr. Asnake from Ethiopia talked about a strategy for
reducing stigma and discrimination. He explained that, before training,
many voluntary counseling and testing (VCT) counselors believed that
HIV+ clients should abstain from sex completely. They did not even see
a reason for discussing family planning with their HIV+ clients. After
receiving training, counselors in VCT clinics were able to provide
their clients with condoms and pills directly and refer them to other
sites for other family planning methods. In your own experience, either
as a provider or client, have you seen examples of provider
discrimination and insensitivity to HIV+ clients? What has been done in
programs in your country to address this problem
- Click on the full text daily digest below for full
summaries. Two participants also posed questions related to the above
presentations.
Day 2. Case study on client-provider interaction
Questions:
- What are some of the things that you, as a provider, try to
remember when counseling your clients?
- What experiences have you had
as a client that illustrate
good or bad counseling?
Day
2 Summary:
On Day 2, we presented a case study on client-provider interaction.
This scenario presents a situation in which an HIV+ woman visits an HIV
provider looking for information about family planning. It also
demonstrates some of the principles of good client-provider interaction
and counseling principles. Participants were asked to read the case
study and respond to specific questions about the scenario.
A participant from Ghana also posted a contribution highlighting three
important topics; 1) common misconceptions about contraception; 2)
integrating FP into ART services; and 3) provider training on stigma
reduction strategies.
Day 3.
Two participants posted contributions today. One participant from
Zambia described a program called "Circle of Friends" where satisfied
family planning users are able to recruit non-contraceptive users and
introduce them to a family planning provider who would counsel them and
provide a method. Another participant from Sierra Leone described
common misconceptions about contraceptive methods including the
intrauterine device (IUD) and condoms and posed a question to the
experts.
Day 4.
Guest
expert, Dr. Moodley, responded to the question posed by the participant
from Sierra Leone. Another participant asked Dr. Moodley some questions
about her presentation at the March 1 videoconference. Dr. Heidi
Reynolds from FHI also described the Kenyan Ministry of Health’s
approach in integrating FP into VCT and asks for people’s thoughts on
this approach.
Days 5
Several participants posted
comments today. Theresa Hatzell Hoke from FHI, USA talked more about
the study presented by Dr. Moodley and asked others about provider
misconceptions. Dr. Moodley also provided answers to Dr. Yoder's
questions included in the last digest. Dr. Young-Mi Kim from JHU/CCP,
currently working in South Africa, talked about FP counseling
in ART settings and Violeta Ross from Bolivia talked about
women living with HIV. Yvonne Morgan from Sierra Leone discussed the
case study presented early last week. Jeanne Keller and Arnitra, both
from the US, provided ideas on how to counsel the 15 year old client
discussed last week.
Days 6
Today's daily digest
contains the
personal story of Kimberly who found out that she was HIV positive in
1990. Kimberly has shared with us some of her experiences, including
dealing with her diagnosis, disclosing her status, and her interaction
with providers.
Days 7
Today we received
Kimberly's responses to the questions that a forum participant asked
earlier this week.
Days 8
This forum has been a rich
and rewarding
experience; we have exchanged ideas as well as personal and
programmatic experiences. One of the purposes of this forum was to
facilitate ongoing networking and dialogue among program managers,
researchers, and others interested in improving CPI as it relates to
clients’ FP needs within HIV/AIDS service settings. We hope that this
forum has provided you with up-to-date and state-of-the-art information
on what is happening in the field and an opportunity for synergy
between sharing both global and domestic-based experiences.
Post-forum survey results
Number of
surveys completed 31
% who have
passed content to others 66%
% who have or
will use in their work 74%
% very
satisfied with forum content 67%
Suggestions
for improvement :
- Involve more providers in the discussion.
- Less
attention to individual, anecdotal experience and more information
about practices that are proposed, being piloted, or being fully
implemented in service delivery.
Other comments:
- The forum brought me a lot of information and some
experience from colleagues from other developing countries.
- The topics discussed were interesting, but I would have
liked to have read a broader range of topics.
- Sharing from the patients themselves is a great learning
[experience]! My perspective to communicate and work with RH and HIV
has widened and makes me better [prepared] to plan and work on RH/HIV.
References and resources
Click here for related
resources and references in the community library
Reports and publications
There is no text related to this title in the WORD document
Organizing groups
Johns Hopkins Bloomberg School of Public Health’s Center for
Communication Programs (JHU/CCP), with support from the Implementing
Best Practices in Reproductive Health Initiative (IBP) Initiative, the
USAID Maximizing Access and Quality Subcommittee on Client Provider
Interaction (CPI), and the USAID Family Planning and HIV/AIDS
Integration Working Group
Contributing
experts/facilitators
Dr. Jennifer Moodley, Women's Health Research Unit, School of
Public Health and Family Medicine, University of Cape Town
Dr. Saiqa Mullick, Population Council (Frontiers)
Dr. Mengistu Asnake, Pathfinder International
Kimberly, USA, HIV+ Client
Steering committee
This online forum builds upon existing partnerships and
activities among three groups: the Implementing Best Practices in
Reproductive Health Initiative (IBP) Initiative, the USAID Maximizing
Access and Quality Subcommittee on Client Provider Interaction (CPI),
and the USAID Family Planning and HIV/AIDS Integration Working Group
Other acknowledgements
We would like to thank Dr. Arzum Ciloglu and Marian Amoa of
the Health Communication Partnership and Peggy D’Adamo and Megan
O’Brien of the INFO Project who coordinated this online forum.
Moderators