Impact of Structured Counseling with Trained Counselors in Choosing a Modern Contraceptive Method in India

Abstract

Objective: The study was designed to determine the impact of structured counseling by trained contraceptive counselors in a real-life clinical setting on the adoption of modern contraceptive methods in comparison with past contraceptive experience. Methods: Current study was a retrospective, non-interventional design, from the data collected in the time period of March to September 2013 across four clinics with predominant obstetric and gynecological practice. Three hundred and fifty-one women consulting for contraception were counseled by trained counselors using standardized counseling tools. Results: Of the 351 women counseled, 40.74 % (n = 143) had never used a contraceptive (no method) and 42.74 % (n = 150) women whose partner had or were using a “male condom.” Post-counseling by a trained counselor, there was a significant (p < 0.001) increase in modern contraceptive use (91.74 %, n = 322) versus prior counseling (52.14 %, n = 183) proportion of women who had or were using a modern contraceptive. The change observed for each method pre-counseling (usage history) to post-counseling was as follows: combined oral contraceptive (COC) 1.99–5.41 %, progesterone-only pill (POP) 0.85–30.48 %; copper intrauterine device (Cu-IUD) 4.27–29.4 %; injectable contraceptive 1.71–20.51 %; male condom 42.74–1.42 %; no method 40.74–7.41 %; traditional 7.12–0.85 %; and sterilization 0.28–1.71 %. Conclusion: This study is a first of its kind, conducted in the private sector, and clearly highlights the benefits of a trained counselor in contraceptive counseling with a significant proportion of women choosing a modern contraceptive. With a busy private practice, a trained counselor facilitates the clinician’s role and helped the women to choose a suitable modern contraceptive method.