Client-Provider Communication in Family Planning: Assessing Audiotaped Consultations from Kenya

Published by The Johns Hopkins School of Public Health Center for Communication Programs (JHU/CCP), this working paper (#5) is one of several that describe JHU/CCP's views about a given theme or topic and illustrate, via descriptions of various projects in many countries, how the lessons of experience led to such a view. The publication contains an extensive bibliography for further reference.

From the Preface
"The purpose of this Working Paper is to share a new perspective and additional information on client-provider communication that has been gained from a novel methodology. In recent years, JHU/PCS [Johns Hopkins University/Population Communication Services] staff have pioneered the application of interaction analysis - that is, the analysis of audio- and videotaped consultations - to the family planning setting in order to understand more fully the complex behavior of clients and providers. Interaction analysis has helped shift the focus from provider to client behavior and has led to new hypotheses about what "quality" means in family planning counseling. This paper explores two key quality of care issues: how clients and providers communicate with one another and how decisions are made during consultations. Although this paper uses Kenya as a case study, ongoing interaction analyses from Ghana, Indonesia, and Peru confirm the value of the approach. It has proved useful for advancing provider training, for post-training reinforcement interventions, and for situation analysis and evaluation. The data analyzed in this study were drawn from the Kenya Client-Provider Information, Education, and Communication (IEC) Project, 1991-1994..."

Table of Contents

• Chapter I. Introduction
  • Client-Provider Communication
  • Objectives
  • Interaction Analysis
  • Organization of the Report
• Chapter II. Data Collection
  • Data Sources
  • Characteristics of the Sample
  • Outcomes of Counseling Sessions
• Chapter III. Client Participation
  • Methods of Data Analysis
  • Interaction Styles
  • Balance of Talk
  • Active Client Communication
  • Provider Influence on Client Communication
  • Rewarding Active Participation
• Chapter IV. Choosing a Contraceptive Method
  • Methods of Data Analysis
  • Understanding the Purpose of the Decision
  • Learning about the Alternatives
  • Weighing the Options
  • Implementing the Decision
• Chapter V. Counseling Continuing Clients
  • Reason for Return Visits
  • Participation by Continuing Clients
  • Decision-making by Continuing Clients
• Chapter VI. The Value of Interaction Analysis
  • Advantages
  • Limitations
  • Future Directions
• Chapter VII. Discussion And Practical Implications
  • Encouraging Client Participation
  • Encouraging Informed Choice
  • Encouraging Continued Use
• Chapter VIII. Changing Client And Provider Behavior
  • Communication Campaigns
  • Client Educational Materials and Activities
  • Provider Training
  • Provider Reinforcement
• References
• Appendices
  • Appendix A. Code Guides
  • Appendix B. Client Participation by Client and Provider Characteristics
  • Appendix C. Accuracy of Information