Afield test with the NORMAL jobaid cor community health volunteers

Introduction: Concerns about contraceptive-induced menstrual

changes (CIMCs) contribute to nonuse and discontinuation of family

planning (FP). Current counseling materials inadequately address

these concerns. After obtaining initial feedback, we field-tested an

adapted version of the NORMAL job aid that guides community

health workers on how to counsel women about CIMCs. The field

test aimed to help understand how the job aid was used, the challenges

faced in using it, and recommendations to improve the job

aid.

Methods: Sixteen community health volunteers (CHVs) from 2 subcounties

in Kenya were trained on the 2-page job aid and given

copies of the job aid to use with clients. Six to 8 weeks after the

training, we interviewed the CHVs about their experiences using

the job aid. The interviews were audio-recorded, transcribed, and

analyzed to identify qualitative themes.

Results: All 16 CHVs reported using the job aid each time they

counseled. All liked it and said they used it because it gave

them new information and made counseling easier. All reported

offering the job aid to most clients and that most clients accepted

a copy. CHVs noted clients referred their friends and family to

them after counseling using the job aid. CHVs said the job aid

reduced clients’ and their male partners’ concerns about CIMCs

and helped clients select or switch FP methods. Most CHVs did

not have suggestions for improving the job aid.

Conclusion: The job aid was highly acceptable to the CHVs who

participated in this small assessment. According to the CHVs, it

increased counseling effectiveness and may help increase uptake

and continued use of FP methods directly through counseling

or indirectly through diffusion in the community. Though

further research is needed in other settings and to quantify its

impact, we recommend this promising job aid be adapted for

wider use.