outcome of family planning

Providers should inform clients about all contraceptive methods that can be used safely. The .gov means its official. Clinical practice guidelines we can trust. For male clients, providers should screen MSM for gonorrhea at anatomic sites of exposure, in accordance with CDC's STD treatment guidelines (36). With a special focus on meeting . 2014 recommendations for pediatric preventive health care. Providers should assess the current pregnancy status of clients receiving contraception (. The clinical visit should focus on understanding the client's reproductive life plan (24) and her difficulty in achieving pregnancy through a medical history, sexual health assessment and physical exam, in accordance with recommendations developed by professional medical associations such as ASRM (101) and ACOG (96). STIs including HIV/AIDS can also be prevented with correct and consistent use of condoms. One wife in Jharkhand shared, Earlier he would not help too much with the children. Available at. Moos M. Preconceptional health promotion: progress in changing a prevention paradigm. Primary care interventions to prevent tobacco use in children and adolescents. The second level comprises related preventive health services (e.g., screening for breast and cervical cancer). Assessment of Family Planning Service Availability and Readiness in 10 African Countries Stock-outs and logistics management problems were common among the countries surveyed. In most cases, a qualitative urine pregnancy test will be sufficient; however, in certain cases, the provider may consider performing a quantitative serum pregnancy test, if exact hCG levels would be helpful for diagnosis and management. J Biosoc Sci. Summary List of Indicators 5 Number/percentage of trainees competent to provide a specific family planning service Number/percentage of trained providers assessed to be competent at a specific period (e.g., 6 months) post-training Number/percentage of trainees who apply the skills to their subsequent work C. Commodities and Logistics Pipeline wastage In addition, to learn more about factors that might influence a client's choice of a contraceptive method, providers should confirm the client's pregnancy intentions or reproductive life plan, ask about the client's contraceptive experiences and preferences, and conduct a sexual health assessment. Outcomes to be achieved by End of Project - Family Planning. has been using a reliable method of contraception correctly and consistently. Are you confident that you can discuss family planning issues with women and their partners during pregnancy and the postpartum period? The family nursing process is the same nursing process as applied to the family, the unit of care in the community. Males with symptoms suggestive of chlamydia (urethral discharge or dysuria or whose partner has chlamydia) should be tested and empirically treated at the initial visit. Among live births, only 1% of infants are placed for adoption within their first month of life (99). As a result, multiple professional medical associations have emphasized the importance of providing confidential services to adolescents (6870). Providers should follow USPSTF recommendations (Grade B) to screen women aged 5074 years on a biennial basis; they should screen women aged <50 years if other conditions support providing the service to an individual patient (140). It encourages programs to explore effective ways to design and implement systems and services to achieve expected outcomes for families and children. For example, the client might come in for acute care (e.g., a male client coming in for STD symptoms or as a contact of a person with an STD), for chronic care, or for another preventive service. Care does not vary in quality because of the personal characteristics of clients (e.g., sex, race/ethnicity, geographic location, insurance status, or socioeconomic status)., Evidence-based. Lederman RP, Chan W, Roberts-Gray C. Parent-adolescent relationship education (PARE): program delivery to reduce risks for adolescent pregnancy and STDs. Research on family planning practices among the military population in low-income and middle-income countries is limited. Both female and male sterilization are safe, are highly effective, and can be performed in an office or outpatient surgery setting (40,41). To practise your skills at family planning counselling. The term "service site" represents the numerous settings in which family planning services are delivered, which include freestanding service sites, community health centers, private medical facilities, and hospitals. The Expert Work Group considered the core recommendations by using the following criteria: 1) the quality of the evidence; 2) the positive and negative consequences of implementing the recommendations on health outcomes, costs or cost-savings, and implementation challenges; and 3) the relative importance of these consequences, (e.g., the likelihood that implementation of the recommendation will have a substantial effect on health outcomes might be considered more than the logistical challenges of implementing it) (20). Health and Human Services. Performance measurement and evaluation: definitions and relationships. Smith RA, Brooks D, Cokkinides V, Saslow D, Brawley OW. The seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 483: primary and preventive care: periodic assessments. Contraception 2013;87:15461. Male clients concerned about their fertility should have a semen analysis. Planning and outcome identification is the third step of the nursing process and includes both establishing guidelines for the proposed course of nursing action to resolve the nursing diagnoses and developing the client's plan of care.After the nursing diagnoses and the client's strengths have been identified, planning begins. 12, FAMILY PLANNING COUNSELLING. CDC. Bethesda, MD 20894, Web Policies This includes physicians, physician assistants, nurse practitioners, nurse-midwives, nursing staff, and health educators. Forgone health care among U.S. adolescents: associations between risk characteristics and confidentiality concern. Contraception 2011;83:397404. is 7 days after spontaneous or induced abortion. Step 3. This report can assist primary care providers in offering family planning services that will help women, men, and couples achieve their desired number and spacing of children and increase the likelihood that those children are born healthy. It is not appropriate to omit presenting information on a method solely because the method is not available at the service site. Committee Opinion No. The health benefits include sizable reductions in maternal, newborn, and child morbidity and mortality, as well as deaths . Beerthuizen R. State-of-the-art of non-hormonal methods of contraception: V. Female sterilisation. Providers should be aware that the USPSTF also has recommended that certain screening services not be provided because the harm outweighs the benefit (see Appendix F). The Lactational Amenorrhea Method (LAM): a postpartum introductory family planning method with policy and program implications. The lowest effective staff supports consist of a screening nurse who advises primary care clinicians of a positive screen and provides a protocol facilitating referral to behavioral therapy. Indicates that screening is suggested only for those persons at highest risk or for a specific subpopulation with high prevalence of infection or other condition. Am Fam Physician 2007;76:397400. Available at, CDC. Atlanta, GA: US Department of Health and Human Services, DCD; 2006. Family planning services can help address these and other public health challenges by providing education, counseling, and medical services ( 5 ). ABCs of measurement. Educational materials and programs can be provided to parents or guardians that help them talk about sex and share their values with their child (72,87). Additionally, family planning (FP) outcomes are not always a focus of research and evaluations and are not routinely measured by programs. Site has written agreements (e.g., MOUs) with the key partner agencies for health care (especially prenatal care, primary care, HIV/AIDS) and social service (domestic violence, food stamps) referrals. FOIA It is achieved through the use of contraceptive methods and the treatment of involuntary infertility. How relationships of US men affect contraceptive use and efforts to prevent STD. Primary care protocol for transgender patient care. In some cases women may feel more comfortable if their partners are not present or if their partners are counselled on their own and/or by a male counsellor. . Labbok M, Perez A, Valdez V, et al. On the economic aspect, recent case studies of India and Nigeria, for example, show that if both countries were to meet their family planning commitments by 2030, India could potentially reduce its overall household expenses by US$89.7bil and Nigeria by US$12.9bil. Trussell J. Performance measures provide information about how well the service site is meeting pre-established goals (148). Explore ways you can work with adolescents, youth groups and schools to reach adolescents who may need support. A female client might wish to include her partner in the discussion; however, if a client chooses not to involve her partner, confidentiality must be assured. American Academy of Pediatrics. Family Planning Programs: Quality of Care. US Preventive Services Task Force. Background . J Cult Divers 2009;16:14050. The national standards for culturally and linguistically appropriate services in health and health care. The concept 'quality of care' has been an important and widely accepted dimension of family planning programs for the past decade. Source: CDC. 1997 Apr;29(2):141-9. doi: 10.1017/s0021932097001417. US Department of Health and Human Services, Office of Minority Health. Go to: Birth spacing and postpartum family planning Family planning is about deciding how many children you choose to have and when you want to have them (timing of pregnancies and birth spacing). Langley G, Nolan K, Nolan T, Norman C, Provost L. The Improvement Guide: A practical approach to enhancing organizational performance. Adolescents' access to care: teenagers' self-reported use of services and perceived access to confidential care. The typical effectiveness of Food and Drug Administrationapproved contraceptive methods. Am J Public Health 2004;94:134751. Available at www.uspreventiveservicestaskforce.org/uspstf11/cervcancer/cervcancerrs.htm. 2nd ed. The planning occurs in three phases: initial, ongoing, and . When working with any client, encourage partner communication about contraception, as well as understanding partner barriers (e.g., misperceptions about side effects) and facilitators (e.g., general support) of contraceptive use (4346). RR-4]). However, the USPSTF recommendation for screening for other drugs in adults, and for alcohol and other drugs in adolescents, is an "I," and patients should be informed that there is insufficient evidence to assess the balance of benefits and harms of this screening (107,110). BMC Public Health. Women aged <25 years are at highest risk for gonorrhea infection. Clients interested in sterilization should be referred to an appropriate source of care if the provider does not perform the procedure. Oringanje C, Meremikwu MM, Eko H, Esu E, Meremikwu A, Ehiri JE. One example of a systematic approach to improving the quality of care is the "Plan, Do, Study, and Act" (PDSA) model (147,156), in which staff first develop a plan for improving quality, then execute the plan on a small scale, evaluate feedback to confirm or adjust the plan, and finally, make the plan permanent. There is a clear link between family planning, women empowerment, and human capital development. The impact of publicly funded family planning clinic services on unintended pregnancies and government cost savings. Women with incomes below 100 percent of the federal poverty level are not charged. India's family planning programme advertised the small middle-class family as a means to develop the nation. Corresponding preparers: Loretta Gavin, PhD, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. The client should be informed that some medications might be contraindicated in pregnancy, and any current medications taken during pregnancy need to be reviewed by a prenatal care provider (e.g., an obstetrician or midwife). Riley W, Moran J, Corso L, Beitsch L, Bialek R, Cofsky A. Providers also may inform clients about the availability of emergency contraceptive pills and may provide clients an advance supply of emergency contraceptive pills on-site or by prescription, if requested. Job aids and other resources for use in service sites are being developed and will be made available when ready through OPA's website (http://www.hhs.gov/opa). Optimal evaluation of the infertile female. Clin Pediatr (Phila) 1991;30:3059. We define the goals of male involvement interventions as: The interventions are often labeled male involvement, but they can have other names as well and encompass a variety of activities. You can then help them assess if this method suits their situation and needs (e.g., Are you confident you could remember to take a pill every day? A life-course approach incorporating appropriate preconception and contraception care is key to achieving optimal maternal, neonatal, and child health outcomes. It has been shown that a dollar (acting as any unit of currency) invested in family planning can yield a healthcare cost savings in maternal care and newborn services of four dollars, and a dollar invested in the highly effective hormonal implant contraceptive, for example, can yield a healthcare cost savings of 16 dollars. American College of Obstetricians and Gynecologists. Women who are using contraception to prevent or delay pregnancy might also benefit from preconception health services, especially those at high risk of unintended pregnancy. Various methods of CONTRACEPTION can be used to. How many (more) children would you like to have and when? The panels provided individual feedback about which clinical preventive services should be offered in a family planning setting and which clinical recommendations should receive the highest consideration. Source: Donabedian A. As the U.S. health-care system evolves in response to increased efforts to expand health insurance coverage, contain costs, and emphasize preventive care (9), providers of family planning services will face new challenges and opportunities in care delivery. Voices of Asian American youth: important characteristics of clinicians and clinical sites. 6th ed. For many women and men of reproductive age, a family planning service site is their only source of health care; therefore, visits should include provision of or referral to other preventive health services. A pelvic examination should assess for: pelvic or abdominal tenderness, organ enlargement or mass; vaginal or cervical abnormality, secretions, or discharge; uterine size, shape, position, and mobility; adnexal mass or tenderness; and cul-de-sac mass, tenderness, or nodularity. RR-6). In other words, family planning is voluntary, and available methods of contraception (previously referred to as birth control) can be customized to individual needs with a range of methods that are acceptable to all, effective, and easy to use like Plan B. Unmet need for family planning applies only to married women and indicates those women who say they prefer to avoid a pregnancy but are not using any method of contraception. In some places research has shown that family planning method use is more successful when partners choose and agree upon a method together. National Quality Forum. In: LJ S, ed. US Department of Health and Human Services. Nearly half (49%) of all pregnancies are unintended (1). Step 4. For female and male clients, providers should screen clients for syphilis, in accordance with CDC's STD treatment guidelines (36). American Academy of Pediatrics. Washington, DC: The National Academies Press; 2011. Washington, DC: The National Academies Press; 2010. It might not be feasible to deliver all the needed services in a single visit, and they might need to be delivered over the course of several visits. In a given year, approximately 20% of adolescent births represent repeat births (88), so in addition to providing postpartum contraception, providers should refer pregnant and parenting adolescents to home visiting and other programs that have been demonstrated to provide needed support and reduce rates of repeat teen pregnancy (8994). Site offers on-site HIV testing (using rapid technology). Females with gonnorrhea infection should be re-screened for re-infection at 3 months after treatment. guidelines for adolescent health care. * Key principles of providing quality counseling including education have been outlined (Appendix C). When serving contraceptive clients who return for ongoing care related to contraception, providers should ask if the client has any concerns with the method and assess its use. Similarly, services for adolescents should be provided in a "youth-friendly" manner, which means that they are accessible, equitable, acceptable, appropriate, comprehensive, effective, and efficient for youth, as recommended by the World Health Organization (34). Steps in providing contraceptive services, including contraceptive counseling* and education. Services for adolescents should be provided in a "youth-friendly" manner, which means that they are accessible, equitable, acceptable, appropriate, comprehensive, effective, and efficient for youth as recommended by the World Health Organization (34). Following these recommendations is important both to ensure clients receive needed care and to avoid unnecessary screening of clients who do not need the services. A womans ability to space and limit her pregnancies has a direct impact on her health and well-being as well as on the outcome of each pregnancy.. For female and male adult clients, providers should screen for alcohol use in accordance with the USPSTF recommendation (Grade B) for how to do so, and provide behavioral counseling interventions, as indicated (107). Pallitto CC, Campbell JC, O'Campo P. Is intimate partner violence associated with unintended pregnancy? Persons likely to be at high risk include injection-drug users and their sex partners, persons who exchange sex for money or drugs, sex partners of HIV-infected persons, and MSM or heterosexual persons who themselves or whose sex partners have had more than one sex partner since their most recent HIV test. These recommendations focus on the direct delivery of care to individual clients. One high-intensity behavioral counseling model that is similar to the contraceptive counseling model is Project Respect (133), which could be implemented in family planning settings. Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial. Women with regular menstrual cycles should be advised that vaginal intercourse every 12 days beginning soon after the menstrual period ends can increase the likelihood of becoming pregnant. Providing men and women the opportunity to engage in family planning discussions as part of maternity caretogether or separatelycan directly address these inequitable norms and create space for joint decision-making for effective use of family planning. Evans WD, Davis KC, Ashley OS, Blitstein J, Koo H, Zhang Y. Efficacy of abstinence promotion media messages: findings from an online randomized trial. Recommendations for contraceptive use are available (42). Is there a consistent pattern of performance among providers? Screening for high blood pressure in adults. Am J Obstet Gynecol 2006;194:12905. * No special evaluation needs to be done prior to making condoms available to males. The United States continues to face substantial challenges to improving the reproductive health of the U.S. population. Family planning services are embedded within a broader framework of preventive health services (Figure 1). Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women. It may also be helpful to explain emergency contraception, and offer her emergency contraceptive pills to take home in case she needs them. If the client is using the method correctly and consistently and there are no concerns about continued use, an appropriate follow-up plan should be discussed and more contraceptive supplies given (42).

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