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Citation

MacLachlan, Ellen W.; Agali, Balki Ibrahim; Maytan-Joneydi, Amelia; Chaibou, Sanoussi; Garba, Souleymane Amadou; Halidou, Illiassou C.; Speizer, Ilene S.; & Nouhou, Abdoul M. (2023). Qualitative Assessment of Providers’ Experiences with a Segmentation Counseling Tool for Family Planning in Niger. Reproductive Health, 20(1), 71. PMCID: PMC10170744

Abstract

INTRODUCTION: This study examines experiences with a family planning segmentation counseling tool that is used during the provision of family planning services. Based on answers to a series of questions, women are segmented into one of five categories of family planning users and counseled based on their identified segment. This study aimed to qualitatively assess provider perspectives on implementation of the tool.
METHODS: Semi-structured in-depth interviews took place in the Dosso region of Niger among 16 family planning providers who had been trained in segmentation and were currently using the segmentation tool. The facilities chosen for interviews were part of a larger mixed methods study assessing the impact of using the segmentation approach. Interview questions focused on training, supervision, how segmentation occurs at the health facility, how segmentation changes provider-client interactions, and any difficulties faced with implementation. Interviews were translated and transcribed into French and data were coded and thematically analyzed.
RESULTS: All providers in the study reported positive outcomes associated with segmentation. While providers acknowledged that the segmentation approach added time to the clinic visit, they did see the benefit of this extra time in providing more meaningful interactions between clients and providers, leaving clients with a deeper understanding of family planning and of the different methods available. The implementation of the tool did not change other aspects of service delivery, except that a segmentation sheet was required to be filled in and kept in each patient's file. Difficulties reported included translating the segmentation tool questions into local languages, training enough health care providers and avoiding stock outs of the segmentation sheets.
CONCLUSION: The segmentation process is of benefit to family planning clients in Niger and the scale-up of the strategy could bring higher quality services to women. If this approach is brought to scale the implementation challenges uncovered need to be addressed, especially adequate training. Further research is needed to determine if segmentation leads to changes in family planning use outcomes.
This is a study about what nurses and other health care staff in Niger think about a segmentation counseling tool that is used during family planning services. Segmentation means that during counseling each woman is asked a series of questions and, depending on her answers, she is segmented into one of five ‘client type’ categories and counseled based on that ‘client type’ or segment. Face-to-face interviews with health care staff took place in the Dosso region of Niger among 16 staff who were using the tool with their patients. The facilities chosen for interviews were part of a larger study assessing how well segmentation was working. Staff were asked about training, supervision, how segmentation occurs at the facility, how segmentation changes how they interact with patients, and any difficulties faced with implementation. All the interviews were then analyzed. All providers in the study had positive things to say about segmentation, including the benefit of spending extra time with each client. This extra time results in more meaningful interactions between clients and providers, leaving clients with a deeper understanding of family planning and of the different methods available. Difficulties reported included translating the segmentation tool questions into local languages, training enough health care providers and avoiding stock outs of the segmentation sheets. The segmentation process is of benefit to family planning clients in Niger and can contribute to higher quality family planning services for women. The challenges that were found need to be addressed, especially adequate training.

URL

http://dx.doi.org/10.1186/s12978-023-01617-9

Reference Type

Journal Article

Year Published

2023

Journal Title

Reproductive Health

Author(s)

MacLachlan, Ellen W.
Agali, Balki Ibrahim
Maytan-Joneydi, Amelia
Chaibou, Sanoussi
Garba, Souleymane Amadou
Halidou, Illiassou C.
Speizer, Ilene S.
Nouhou, Abdoul M.

Article Type

Regular

PMCID

PMC10170744

Continent/Country

Niger

Sex/Gender

Women

ORCiD

Speizer - 0000-0001-6204-1316