Using a job aid to assist family planning counseling decision-making in the field.

The algorithm developed by APROSAMI a family planning (FP) agency in Lima Peru and by CENPRUF an FP agency in Trujillo and the Population Council which bridges the gap between quality control theory and practice is described. The algorithm identifies quality oriented norms for the provider client interaction provides a derivation for a job aid for use in service provision and indicates a strategy for evaluation of the results from use of the tool. A flow chart is provided which shows the FP agent operating within the community. Since client concerns vary the provider uses different service behavior. The algorithm specifies the behavior before every client contingency. The resulting norms are very specific but lack detailed technical information. Providers with low levels of education may have difficulty following the instructions. For instance the provider must discriminate between common side effects of a particular method and pathological conditions. However in conjunction with the performance booklet YES go on and NO instructions and technical information expand the knowledge and skills of the provider of the algorithm. Specific information includes the rules of usage of each user-dependent method as well as the addresses of clinics that provide specific contraceptives. An example from several pages in the booklet is included in figure 2. Community-based distributors have been trained to use this algorithm in their 30-minute home-based visits. User satisfaction is evaluated by a checklist of behavioral questions about the user-provider relationship. A scoring system is based on the providers % of correct behaviors. A current evaluation is underway to evaluate visits to the 300 distributors in this operations research project.