FHI - Service Delivery Tools

Family Health International (FHI) develops and publishes service delivery guidebooks and job aids for health care providers and health educators -- practical materials to use when serving clients in clinical or counseling settings, or when designing programs to improve health care. Provider checklists, posters, information packets, visual aids, slide presentations, and activity kits are among the types of tools offered by FHI.

Menu of Practices: Practical Guidance for Improving Reproductive Health and Family Planning Policy and Programming (2008). A large gap still exists between the spheres of research and practice, leading to delays of a decade or longer before widespread use of conclusive evidence. The "Menu of Practices" briefs aim to bridge this gap by ensuring that policy-makers, health practitioners, and other decision-makers are able to quickly and efficiently access, understand, and implement recommendations stemming from new and under-used research findings in reproductive health and family planning. Each of the menus in this package offers recommendations to improve reproductive health policies and practices, as well as suggested tools and resources to support implementation.

Long-Acting and Permanent Methods (LAPMs): Addressing Unmet Need for Family Planning in Africa (2008). This package of eight briefs outlines the benefits of LAPMs and the rationale for introducing or revitalizing these methods within national reproductive health and family planning programs. They are meant to inform policy-makers, program managers, and donors, as well as diverse stakeholders at the community level who wish to improve and expand LAPM provision within their communities.

IUCD Method Briefs: A New Look at IUDs (2003). Increasing access to and provision of the IUD is a way of expanding women's contraceptive choices. The device is safe, effective, reversible, and is an extremely low-cost option. The IUD is a convenient method for both client and provider, and has minimal associated health risks. It can also be a contraceptive option for HIV-positive clients. This information packet summarizes the many benefits of the intrauterine device (IUD).

Improving Access to Family Planning: Community-based Distribution of DMPA (2007). This kit provides information and tools for decision-makers to use to advocate for and initiate community-based distribution (CBD) of the injectable contraceptive depot-medroxyprogesterone acetate (DMPA, or Depo-Provera).

DMPA Provision by Community-Based Reproductive Health Workers in Africa (2007, PDF, 695 KB). This manual provides information about depot-medroxyprogesterone acetate (DMPA) to community-based health workers so that they can offer safe, high-quality services to women who may not be able to reach a clinic.

Meeting the Needs of Young Clients: A Guide to Providing Reproductive Health Services to Adolescents (2000). This manual is meant to help family planning providers and health care workers strengthen the reproductive health care and services offered to young women and men.

Evaluating Programs for HIV/AIDS Prevention and Care in Developing Countries: A Handbook for Program Managers and Decision Makers: Chapter 3 (2001). The third chapter of this 276-page guide covers the evaluation of behavior change communication interventions.

Evaluating Programs for HIV/AIDS Prevention and Care in Developing Countries: A Handbook for Program Managers and Decision Makers: Chapter 6 (2001). The sixth chapter of this 276-page guide covers the evaluation of voluntary HIV counseling and testing programs.

Religious-Based Initiatives: HIV/AIDS Prevention and Control Series (1997). This 69-page guide serves as a theoretical and practical reference for program managers, community and religious leaders, and others planning, implementing, or evaluating religious-based HIV/AIDS prevention efforts.

How to create an effective peer education project (1994). This handbook is intended to help field-level planners and implementers conceptualize new peer education projects or strengthen ongoing projects. One of a collection of eight booklets in the Behavior Change Communication Handbooks produced by FHI's AIDSCAP project in 1994, it introduces important concepts in behavior change communication (BCC) in simple, clear language.

Screening Checklists for Family Planning Services (2008). FHI has developed a set of five easy-to-use provider checklists. Four of the checklists are designed to screen women who want to initiate use of combined oral contraceptives (COCs), injectables (DMPA or NET-EN), the copper intrauterine device (Cu-IUD), or implants. The fifth checklist helps providers rule out pregnancy among women who are not menstruating at the time of their visit. The checklists are consistent with the latest medical eligibility criteria published in 2008 by the World Health Organization (WHO).

Checklist for Clients Who Want to Initiate COCs
Checklist for Clients Who Want to Initiate DMPA (or NET-EN)
Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD
Checklist for Screening Clients Who Want to Initiate Contraceptive Implants
How to be Reasonably Sure a Client is Not Pregnant

FHI has also worked with Ministries of Health to adapt the provider checklists so they align with national family planning guidelines and local language and style. For country-adapted checklists, please see:
Uganda Screening Checklists
Kenya Screening Checklists

Training and Reference Guides for Family Planning Screening Checklists (Second edition, 2009). It is recommended that service providers be trained to administer each of the checklists before applying them in their daily work with clients. Each of the five guides in this series provides a training curriculum for learning to use the related checklist, along with supplementary reference materials.

COC Strategy Guide (2008, PDF, 475 KB). This easy-to-use tool assists health workers of all levels in the implementation of four evidence-based strategies recommended by the World Health Organization to increase uptake and continuation of COCs. These strategies include:

Quick Start (women take their first pill under observation during a clinic visit, regardless of where they are in their menstrual cycle)
Advance provision of COCs
Providing multiple packs of COCs
Managing missed pills

Implementing these evidence-based strategies can improve the quality of care and reduce medical barriers for those seeking oral contraception. On many occasions, menstruation requirements or a client's inability to visit health centers for refills restrict or deny access to COCs for eligible women who desire this method. In addition, complicated instructions on when to initiate use of hormonal contraceptives and how to manage missed pills can create unnecessary obstacles to contraceptive uptake and continuance. Using the COC strategy guide can minimize these barriers.

Job Aids for the Reinjection of Injectable Contraceptives (2009). Research conducted by FHI in South Africa has revealed that approximately half of injectable contraceptive users are late for their reinjections, and a substantial portion of those who arrive within the approved grace period are denied a reinjection and told to come back when they are menstruating. FHI and IntraHealth International have field tested and co-branded several job aids designed to help health care providers better serve these women.

Quick Reference Chart (2009). Produced by Family Health International (FHI), this chart is based on the World Health Organization's Medical Eligibility Criteria for Contraceptive Use (2004, revised 2008). It serves as an "at-a-glance" job aid for providers to determine whether clients with certain medical conditions may initiate or continue using combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), contraceptive implants, or the copper intrauterine device (Cu-IUD).

Comparing the Effectiveness of Family Planning Methods (chart, PDF, 219 KB). To make informed contraceptive choices, clients require an accurate understanding of pregnancy risks. A study by Family Health International (FHI), supported by the U.S. Agency for International Development (USAID), showed that a simple counseling chart can improve women's understanding of contraceptive effectiveness better than more complex tools can. In response, a panel composed of representatives of the World Health Organization (WHO), USAID, the INFO Project of the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs, EngenderHealth, FHI, and other experts drafted this chart, which presents contraceptive methods on a continuum of effectiveness. The chart is also available in French and Spanish.