Use of "ABHIBADAN" for Family Planning Counselling and Its Approach

Definition

Family planning counseling is a continuous process that a counselor offers to clients and community members to assist them in making decisions about the number of children they want to have.

Benefit of Family Planning Counseling

• Increased acceptance
  • Giving clients accurate information and encouraging "open" dialogue through listening, speaking, and nonverbal cues encourages them to accept family planning.
• The best strategy to use is
  • Counseling assists clients in selecting the approaches that are best for their unique social and health requirements.
• Effective method use
  • In order for clients to understand how to utilize methods correctly, effective counseling is required.
• Longer usage
  • A customer is more likely to continue using a contraceptive method and be satisfied if she or he takes part in method selection, understands how to deal with any adverse effects, and feels at ease signing contracts and communicating with the service provider.
• Dispel myths and misconceptions
  • Counseling gives clients the chance to identify and correct any misinformation they may have about family planning options. This will increase the method's acceptance, use, and upkeep among clients and the general public.

Principle of Family Planning Counseling

• Focus on Individual Needs of the Client
  • Each spouse's or couple's reproductive behavior is influenced by a number of variables, including family, community, and the availability of family planning options. Thus, one of the most crucial steps in counseling is to take into account and respect the client's individual needs and preferences. Despite being born and raised in the same society, each person has unique rules, values, cultures, and attitudes that guide his behavior. However, keep in mind that a client's needs for family planning change as they age, and that it is important to respect their values, beliefs, and attitudes. The counselor must first be conscious of his own values, beliefs, and attitudes in order to accomplish this.
• Voluntary Choice of Client's Behavior
  • The client will need sufficient knowledge about the options in order to make a voluntary choice. By giving accurate and comprehensive information, the counselors will assist the client in making a decision voluntarily while keeping in mind their needs. It is crucial to understand that the counselor does not decide on behalf of the clients. It is not appropriate to direct the client, provide incentives, or apply pressure.
• Empowerment
  • People that are empowered are better able to recognize their needs, exercise their rights, and make decisions. It's crucial to provide accurate information since it enables the decision-maker to act freely. The counselor must verify the accuracy of the client's information and provide information as required. It gives the client more power.
• Confidentiality
  • Because decisions about family planning often involve sexuality, the counselor pays attention to the client's inquiries about sex and fertility and responds accordingly. Additionally, the counselor ensures that each client's confidentiality and maintains strict confidentiality in all interactions with them.
• Consent
  • The client should be informed that consent for a minilaparotomy, laparoscopy, and vasectomy must be given in writing or by thumbprint. The client's consent proves that they were fully informed about the surgical contraceptive methods they selected.

Counseling Process and ABHIBADAN Approach

• Counseling is a continuous process that is interwoven into all parts of family planning; it is not simply the presentation and discussion of information at a single moment during the delivery of services. Throughout the client's visit, counseling techniques should be used and pertinent technical knowledge should be delivered and discussed in a participatory and culturally appropriate manner.
• Depending on the approach in question, there are a number of factors that health personnel should be aware of.
• Aims towards reproduction of the client (Spacing or limiting of births)
• Factors such as the time, travel expenses, pain, or discomfort that may be experienced when using any necessary services.
• Accessibility and supply of additional materials that may be required to use the technique
• The method's advantages and downsides.
• Reversibility
• Both long and short term outcomes
• Every stage of the client's interaction with the client staff includes a function called family planning counseling.

ABHIBADAN Approach

Based on a client's reproductive requirements, the Abhibadan approach to counseling is a systemic counseling technique. The identical phases listed below are covered by what is known as the "GATHER" technique in English and Abhibadan in Nepali.

• G-Greet clients in a friendly way
• A- Ask clients about their family planning
• T-Tell clients about available method
• H-Help clients decide what method they want
• E- Explain how to use the method chosen
• R- Return visits should be planned

It is crucial to emphasize the points listed under each counseling step.

G- Greet the Clients

• Give your clients your undivided attention in the first scenario.
• After offering seats, greet them politely and introduce yourself.
• Inquire about how you can assist them. Inform them that you won't share anything they say with anybody else.
• If the counseling is taking place in a medical facility, you must describe what will happen during the visit, including any physical examinations and laboratory tests that may be required.
• Counseling should be done in a place where no one can overhear you.

A-Ask The Clients About Themselves

• Encourage them to express their wants, uncertainties, worries, and any questions they may have.
• If they are new, record their name, age, marital status, number of births, number of living children, usage of family planning in the past and present, and basic medical history on a standard form or checklist from your health management information system.
• Tell them why you need this information so you can provide them the right information and let them choose the family planning strategy that works best for them.
• Ask simple, succinct questions while paying attention to the other person.
• The names of numerous illnesses and medical problems are not well known. Pose specific queries to them. Asking questions like "Do you suffer any discomfort when urinating?" or "Have you had any headaches in the last two weeks?" or "Have you had any genital itching." Do not ask, "Have you experienced any recent illnesses."
• If you have previously met the client(s), inquire as to whether anything has changed since then.

T- Tell Them all About Family Planning Methods

• Inform them about the possible techniques.
• Find out the methods they are interested in and what they already know about them.
• Give a brief explanation of each method of interest, including how it functions, its benefits and drawbacks, and any potential adverse effects.

H-Help Them to Choose a Method

• Inquire about their plans and family circumstances to assist them in selecting a method of birth control. Start by discussing the current situation if they are unsure about the future.
• Find out what the partner or spouse prefers and wishes to use.
• When necessary, repeat information after them and inquire if there is anything they don't understand.
• When the method they selected is unsafe for them, be sure to clearly explain why it might not be the best option and assist them in selecting another one.

E-Explain How to Use a Method After a Method has Been Chosen

• Provide materials as necessary.
• If the method can't be applied right away, describe how, when, and where it will be done.
• A consent form will need to be signed by the client for procedures like voluntary sterilisation. The form indicates that the user wants the method, has been made aware of it, and is aware of this information. You must assist the person in comprehending the consent form.
• Describe how to apply the technique.
• Request a repeat of the directions from the client.
• Tell them what to do if any side effects or warning signals arise, and describe any potential adverse effects.
• Ask them to tell you this information again.
• If there is printed information on the method you want them to use, give it to them.
• Give them a date for their follow-up appointment and encourage them to return earlier if they so choose or if any side effects or warning signs manifest.

R-Appoint a Return Visit for Follow-up

• Ask the client if she or they are still using the method and if there have been any issues during the follow-up visit.
• Inquire about any possible adverse effects.
• Assure the client that the adverse effects are only minor.
• Describe how the side effects are not harmful and offer suggestions for how to get rid of them.
• If you experience severe adverse effects, seek medical attention.
• Inquire about the client's questions.

The following ABHIBADAN model can be used to help clients remember the counseling process.

• "A' Step for abhibadan: "A" abhibadan garne ie, to greet the client and make his/her comfortable to establish good report with the client the service provider should:
• "BHI" Bhinna na thani awashyakta patta lagaune sodh puch garne
• "Ba" Baadha hatauna soochana uplabdha garanue i.e, provide information for solving problems
• "Da" Datta Chitta bhai sahayog garne i.e, Help whole heartedly
• "Na" Namasker gardai pheri auna anurodh garne Anurodh garne i,e, Bidding good bye and asking clients to come again:

Family Planning Counselling- the  BRAIDED Approach

You can use the acronym BRAIDED to help you keep track of what to discuss when advising clients on particular approaches. It represents:

• B-Benefits of the method
• R-Risks of the method, including consequences of method failure
• A-Alternatives to the method (including abstinence and no method)
• I-Inquiries about the method (individual's right and responsibility to ask)
• D- Decision to withdraw from using the method. without penalty
• E-Explanation of the method chosen
• D-Documentation of the session for your ow records