Using Mystery Clients to Assess the Intra Uterine Contraceptive Device (IUCD) Recommending Practices and Client Counseling Behavior of Providers

Abstract

Background: Since 2009, PSI/Nepal has been implementing the Women’s Health Project (WHP) to improve the reproductive health of women, with several goals, including: to increase contraceptive prevalence rate, to decrease the rate of maternal mortality, and to reduce the national fertility rate. Currently, WHP is operational in 50 of 75 districts. PSI/Nepal’s WHP activities focus on identifying and supporting private service providers, increasing demand for IUCDs through interpersonal communication (IPC) and mass media, and improving access to IUCDs by increasing the number of service delivery points through the establishment of PSI network providers and increasing women’s access to IUCDs through increased IUCD service delivery points through the establishment of PSI network provider. Methods: For the purpose of this study, 30 program districts were selected using probability proportionate to size procedure. The target population for this study was PSI/Nepal’s network providers. The mystery client (MC) methodology was used to collect information at provider facilities. Results: The majority of clients were satisfied with the provider’s service. More than two-third (78%) providers asked clients about their preferred choice of FP method. Most (92%) of the providers explained about the different available FP methods. The majority shared basic information on IUCDs with clients and recommended them to use IUCDs (96.3%), and 87.3% offered IUCD services to clients. The majority did not use communication materials or toolkits during counseling despite the availability of BCS tool kits. Conclusions: Program should stress counseling and informed choice on all FP methods. Keywords: counseling; FP methods; IUCDs; mystery clients; PSI network providers.