Promoting family planning
Social science and operations research
Barriers to services
Following a research study carried out by HRP, Senegal has incorporated WHO's pregnancy checklist into its national family planning client card. The checklist has also been introduced into all public sector clinics in Guatemala, as well as urban clinics of the Asociación Pro Bienestar de la Familia (APROFAM), a non-profit, private organization.
In many countries, women are unnecessarily refused family planning services, simply because, when they go to the clinic, they are not menstruating and, as a result, staff consider that there is a risk that they might be pregnant.
A study in Guatemala, Mali and Senegal has evaluated whether use of a “pregnancy checklist” could help providers determine more accurately which clients are likely to be pregnant, and thus avoid refusing services unnecessarily. A total of 4823 women attending 16 clinics were included in the study. In Guatemala, women who were not menstruating were initially six times more likely to be
refused their preferred contraceptive method than those who were menstruating. Use of the checklist significantly reduced refusal rates in both Guatemala and Senegal. In Mali, however, refusal rates were already relatively low, and introduction of the checklist did not lead to any significant change.