2Outline The GATHER approach. Praise and encouragement. The rights of the client.Counseling and motivating men
3GATHERGATHER describes the 6 elements of counseling about family planning and other reproductive health matters.
4G: Greet Patients• Give patients your full attention as soon as you meet them. • Be polite, friendly, and respectful: greet patients, introduce yourself, and offer them seats. • Ensure privacy and confidentiality nonverbally or verbally • Explain what will happen during the visit. • Conduct counseling where no one else can hear.
5A: Ask Patients about Themselves • Ask patients about their reasons for coming and how you can help. • Ask patients about their experience with FP. (HAVE YOU USED ANY FP METHOD BEFORE) • Ask patients what they want to do. Listen actively to what the client says. • Ask for any information needed to complete client records
6T: Tell Patients about Their Choices • Help patients to understand their possible choices. • Tailor information appropriately for the client’s decision. o Ask which methods interest them. If no medical reason prevents it, patients should get the methods they want. o Briefly describe the client’s preferred method regarding Effectiveness, How to use the method, Advantages and disadvantages, side effects and complications o Mention other available methods that might interest the client now or later. o Ask whether the client wants to learn more. o Use samples and other audiovisual materials if possible.
7H: Help Patients Choose • Offer advice as a health expert, but avoid making patients’ decisions for them. • Ask: o “Are you breastfeeding?” o “Do you and your partner want (more) children?” • Ask whether the client wants anything made clearer, repeat as needed. • Explain that some family planning methods may not be safe for patients with certain medical conditions. • Check whether the client has made a clear decision. Specifically ask, “What have you decided to do?” Wait for the client to answer.
8E: Explain What to Do• Explain how to use the method or how to follow other instructions. • Describe possible side effects and what to do if they occur. • Ask the client to repeat instructions. • If possible, give the client printed material to take home. • If the method or services cannot be given at once, tell the client how, when, and where they will be provided. • For voluntary sterilization, the client may have to sign a consent form. Help the client to understand the consent form before she/he signs it.
9R: Return for Follow-Up • Explain when to come back for routine follow-up or more supplies • Explain any medical reasons to return. • Tell patients to come back whenever they wish, if side effects bother them, or if there are medical reasons to return.
10Return visit• Ask whether the client has any questions or anything to discuss. Treat all concerns seriously.• Ask whether the client is satisfied.• Help the client to handle any problems.• Ask whether any health problems have come up since the last visit. Refer patients who need care.• Determine whether the client is using the method or treatment correctly.• If a woman plans pregnancy, suggest where to get prenatal care.
11PRAISE AND ENCOURAGEMENT Praise is the expression of recognition, approval, and admiration. Encouragement is the provision of support, courage, confidence, and hope. The purposes of praise and encouragement are to: • Show that you are listening to the client and valuing what he or she says • Show your support • Motivate the client to continue the discussion (telling and asking)
13Men have special counseling needs Men often prefer to talk to other men.Men Special Counseling Needs• Men need to be encouraged to support women's use of family planning methodsor to use family planning themselves.• Men often have less information or are misinformed about family planning methods• Men are often more concerned about sexual performance and desire than women.• Men often have serious misconceptions and concerns that family planningmethods will negatively impact their sexual pleasure and/or performance.• Men are often concerned that women will become promiscuous if they use FP• Many men do not know how to use condoms correctly. Providers shouldalways demonstrate correct condom use, using a model, when possible.• Men are often not comfortable going to a health facility, especially if it serves women primarily.
14Methods for Counteracting Rumors and Misconception 1. Always listen politely. Don't laugh.2. Define what a rumor or misconception is.3. Find out where the rumor came from4. Explain the facts.5. Use strong scientific facts about family planning methods6. Always tell the truth.7. Clarify information with the use of demonstrations and visual aids.8. Give examples of people who are satisfied users (most convincing).9. Reassure the client by examining her and telling her your findings.10. Counsel the client about all available family planning methods.11. Reassure and let the client know that you care by conducting home visits.