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.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.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.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.
BackgroundTo assess the effects of a communication intervention designed to enhance Jordanian religious leaders' (RLs) communication about family health.
Abstract Objective To assess the effect of a training program designed to enhance the role of Muslim religious leaders (RLs) in promoting family welfare, including reproductive health generally and family planning more specifically. Methods A panel study design was utilized; 136 and 115 RLs completed the self‐administered questionnaires at baseline (pre‐training) and endline (6 months post‐training), respectively. Scales were generated to assess RLs' knowledge of the number of family‐planning methods deemed to be acceptable according to Islamic teachings (9 methods, Cronbach α = 0.85), attitudes toward family planning (7 statements, Cronbach α = 0.67), and preaching and/or counseling on family‐planning topics (7 topics, Cronbach α = 0.85). Results Linear regressions controlling for sex, age, and educational attainment showed that, on average, RLs cited more methods deemed acceptable according to Islamic teachings (β = 1.381; P < 0.001), expressed more positive attitudes toward family planning (β = 0.514; P < 0.05), and preached and/or counseled on family‐planning topics more frequently at endline compared with baseline (β = 0.965; P < 0.01). Conclusion Culturally appropriate training for RLs can lead to a deeper understanding of, and appreciation for, reproductive health and family planning, with the effects manifesting as increased preaching and/or counseling about these important topics.
This article evaluates the effects of involving men in family planning counseling in Jordan using a randomized experiment. We randomly assigned a sample of 1,247 married women to receive women‐only counseling, couples counseling, or no counseling. We measured the effects of each type of counseling on family planning use, knowledge, attitudes, and spousal communication about family planning. Compared to no counseling, couples counseling led to a 54 percent increase in uptake of modern methods. This effect is not significantly different from the 46 percent increase in modern method uptake as a result of women‐only counseling. This outcome may be due, in part, to lower rates of compliance with the intervention among those assigned to couples counseling compared to women‐only counseling. To realize the possible added benefits of involving men, more tailored approaches may be needed to increase men's participation.
