Client-centered counseling improves client satisfaction with family planning visits: evidence from Irbid, Jordan

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Figure 1.
Trends in New Family Planning Clients, Irbid Governorate, August 2008–July 2012
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Figure 2.
Trends in Couple-Years of Protection, Irbid Governorate, August 2008–July 2012

Table 1. Family Planning Services Sought by Clients

Type of Family Planning Service	Total No. of Clients	No. of Clients Who Received Counseling on Day of Interview	No. of Follow-Up Clients
	Received 1 Service
Obtain a method	75	75	0
Counseling	36	36	0
Follow-up/consult	109	0	109
	Received 2 Services
Obtain a method and counseling	73	73	0
Obtain a method and follow-up/consult	67	67	67
Counseling and follow-up/consult	54	54	54
	Received 3 Services
Obtain a method, counseling, and follow-up/consult	47	47	47
TOTAL	461	352	277^a

↵a Of the 277 follow-up clients, 234 received counseling during a previous visit at the health center.

Table 2. Client Satisfaction Associated With Providers' Use of “Consult and Choose” Materials

Materials	Client Satisfaction, % (No. of Clients Reporting Provider Used Material)	Client Satisfaction, % (No. of Clients Reporting Providers Did Not Use Material)
Wheel	89.1^*	72.5^*
Wheel	(n = 156)	(n = 196)
Provider cue card	83.8^*	71.4^*
Provider cue card	(n = 240)	(n = 112)
Hayati Ahla lab coat	88.3^*	63.9^*
Hayati Ahla lab coat	(n = 230)	(n = 122)
Received client cue card	86.9	81.2
Received client cue card	(n = 221)	(n = 85)
Referred to the client cue card	89.9	86.7
Referred to the client cue card	(n = 206)	(n = 15)

Client satisfaction level was defined as “very satisfied.”
↵* Significance comparing satisfaction between clients who recalled that their providers used materials vs. those who did not recall that their providers used the materials. P values ≤ .05 were considered statistically significant.

Table 3. Client Satisfaction Associated With Providers' Use of “Consult and Choose” Counseling Protocol

Counseling Protocol Task	Client Satisfaction, % (No. of Clients Reporting Providers Performed Task)	Client Satisfaction, % (No. of Clients Reporting Providers Did Not Perform Task)
Discussed how many children the beneficiary would like to have	87.7^*	66.9^*
	(n = 219)	(n = 133)
Talked to the beneficiary about advantages of birth spacing	83.0^*	71.0^*
Talked to the beneficiary about advantages of birth spacing	(n = 259)	(n = 93)
Asked the beneficiary whether she had a method in mind before coming to the center	82.7^*	64.9^*
	(n = 295)	(n = 57)
Explained available methods that the beneficiary could use	81.4^*	68.9^*
Explained available methods that the beneficiary could use	(n = 307)	(n = 45)
Made clear the advantages of different methods	82.2^*	67.3^*
Made clear the advantages of different methods	(n = 297)	(n = 55)
Made clear the disadvantages of different methods	81.7^*	71.4^*
Made clear the disadvantages of different methods	(n = 289)	(n = 63)
Talked to the beneficiary about possible side effects of methods	82.8^*	65.6^*
	(n = 291)	(n = 61)
Explained how to manage side effects of the chosen method	83.6^*	55.3^*
Explained how to manage side effects of the chosen method	(n = 305)	(n = 47)

Client satisfaction level was defined as “very satisfied.”
↵* Significance comparing satisfaction between clients who recalled that their providers performed the task vs. those who did not recall that their providers performed the task. P values ≤ .05 were considered statistically significant.

Table 4. Effects of the Hayati Ahla Video on Viewers (n = 52)

Effects Reported by Viewers	No. (%)
Will tell others about the video	52 (100.0)
Believe that such a display should be present in all health centers	52 (100.0)
Watching the video influenced the viewer	44 (84.6)
More acceptance of family planning/modern methods; less fear of modern methods	22 (45.5)
Will use contraception	16 (36.4)
Will ask doctor about family planning/modern methods	14 (31.8)
Will plan family/space 3 years between births	17 (38.6)
Will discuss family planning with spouse/others	10 (22.7)

Table 5. Multivariate Stepwise Logistic Regression Analysis of Variables Associated With Family Planning Client Satisfaction

Variable	Odds Ratios of Being “Very Satisfied” With the Visit
	Model 1	Model 2	Model 3	Model 4	Model 5
Age categories^a	1.4	1.5	1.3	1.4	1.4
Educational attainment categories^b		1.3^*	1.2	1.3	1.2
Adherence to counseling protocol^c			1.2**	–	1.1
Use of counseling materials^d				1.7***	1.6***
No. of observations	461	461	352	352	352

Each successive model reflects the addition of a new variable in the regression analysis to test which variables remain statistically associated with client satisfaction as each new variable is added.
↵* P<.05; **P <.01; ***P <.001
↵a Age categories: 18–20 years, 21–30 years, 31–40 years, 41–49 years.
↵b Educational attainment categories: Basic or lower, secondary, intermediate diploma, university or higher.
↵c Number of counseling protocol steps followed according to the client's recollection.
↵d Number of materials used during counseling according to the client's recollection.