RT Journal Article SR Electronic T1 Client-centered counseling improves client satisfaction with family planning visits: evidence from Irbid, Jordan JF Global Health: Science and Practice JO GLOB HEALTH SCI PRACT FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs SP 180 OP 192 DO 10.9745/GHSP-D-12-00051 VO 1 IS 2 A1 Kamhawi, Sarah A1 Underwood, Carol A1 Murad, Huda A1 Jabre, Bushra YR 2013 UL http://www.ghspjournal.org/content/1/2/180.abstract AB In Irbid, Jordan, a combination of community outreach, using home visits, plays, women's groups, and religious leaders, and improved client-provider counseling based on the “Consult and Choose” approach increased family planning demand and client satisfaction. Service statistic trends suggest increased contraceptive use. Background: High levels of unmet need for family planning and high contraceptive discontinuation rates persist in Jordan, prompting the Jordan Health Communication Partnership (JHCP) to initiate a client-centered family planning service program called “Consult and Choose” (CC), together with community-based activities to encourage women with unmet need to visit health centers. Methods: We held exit interviews with 461 family planning clients between November–December 2011 to assess, from the clients' perspective, whether trained providers followed the CC protocol and used the CC tools, as well as to measure client satisfaction. We also tracked referral card information from community-based activities to health centers and examined service statistics to explore trends in family planning use. Results: On average, clients reported that providers performed 5.6 of the 7 steps outlined in the CC protocol. Nearly 83% of respondents were very satisfied with their clinic visits. Logistic regression analysis found that the odds of being “very satisfied” increases by 20% with each additional counseling protocol step performed and by 70% with each increase in the number of CC materials used. Between June 2011 and August 2012, 14,490 referral cards from community-based activities were collected in health centers, 59% of which were for family planning services. Service statistic trends indicate an increase in the number of new family planning users and in couple-years of protection after starting the CC program. Conclusions: Implementation of the CC program at health centers nationally, in tandem with community-based interventions, could play a key role in attaining Jordan's goal of reducing its total fertility rate to 2.1 by 2030. Although this initiative would likely be replicated most readily in other middle-income countries, lower-resource countries could also adapt the tested CC approach.