Evaluation of the World Health Organization's family planning decision-making tool: improving health communication in Nicaragua

Patient Educ Couns. 2007 May;66(2):235-42. doi: 10.1016/j.pec.2006.12.007. Epub 2007 Jan 23.


Objective: The World Health Organization has led the development of a Decision-Making Tool for Family Planning Clients and Providers (DMT) to improve the quality of family planning counseling. This study investigates the DMT's impact on health communication in Nicaragua.

Methods: Fifty nine service providers in Nicaragua were videotaped with 426 family planning clients 3 months before and 4 months after attending a training workshop on the DMT. The videotapes were coded for both provider and client communication.

Results: After the intervention providers increased their efforts to identify and respond to client needs, involve clients in the decision-making process, and screen for and educate new clients about the chosen method. While the DMT had a smaller impact on clients than providers, in general clients did become more forthcoming about their situation and their wishes. The DMT had a greater impact on sessions in which clients chose a new contraceptive method, as compared with visits by returning clients for a check-up or resupply.

Conclusion: The DMT proved effective both as a job aid for providers and a decision-making aid for clients, regardless of the client's level of education.

Practice implications: Job and decision-making aids have the potential to improve health communication, even or especially when clients have limited education and providers have limited training and supervision.

Publication types

  • Evaluation Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Attitude to Health
  • Communication*
  • Decision Support Techniques*
  • Educational Status
  • Family Planning Services / education*
  • Female
  • Health Personnel / education
  • Health Personnel / psychology
  • Health Services Needs and Demand
  • Humans
  • Inservice Training
  • Male
  • Middle Aged
  • Nicaragua
  • Patient Education as Topic / methods*
  • Patient Education as Topic / standards
  • Patient Participation / methods
  • Patient Participation / psychology
  • Professional-Patient Relations
  • Surveys and Questionnaires
  • Total Quality Management
  • Videotape Recording
  • World Health Organization*