Table 1 Summary of changes and improvements in contraceptive counselling and services 12 months after the QIC
The four driver categories | Changes in clinical practice Subcategories | Team A | Team B | Team C | |||
|---|---|---|---|---|---|---|---|
Maintain | New test | Maintain | New Test | Maintain | New Test | ||
Provide information about contraceptives in a better way before, at and after the first visit. | - Prepare women better, when women call to make an appointment for abortion counseling, that the visit will include contraceptive counselling | X | N | X | |||
- Use a visual tool for information about the effectiveness of different contraceptives | X | X | X | ||||
-Use and hand out an information leaflet about side effects and effectiveness of different contraceptives when women choose contraceptives | X | ||||||
-Use and hand out an information leaflet about side effects when women choose contraceptives | x | x | |||||
-Go over both positive and negative side effects regarding contraceptives | X | X | X | ||||
-Show prototypes for different contraceptive methods | N | N | X | ||||
Develop a respectful approach to counseling, including on contraception, at the time of an abortion | -Introduce and use “Do not disturb” signs | X | |||||
-Schedule more flexible time for contraceptive counselling | X | ||||||
-Avoid scheduling less interested physicians when making abortion counselling appointments | X | ||||||
-Use more open questions in the conversation about contraception | x | x | x | ||||
- Actively include women in the conversation and decision about contraceptives | x | x | x | ||||
Develop better access to LARC at the time of an abortion | -Add more appointments for IUD-insertion post abortion | x | x | x | |||
-Offer/make appointments for IUD-insertion post abortion directly at the time of abortion counseling | x | x | x | ||||
-Offer (“fast track”) insertion of IUD- or subdermal implants within a week post abortion. | N | x | x | ||||
-Increase skills training for midwives in LARC-insertion post abortion. | x | x | x | ||||
-Offer women appointments with midwives instead of physicians to achieve more timely IUD insertion | x | ||||||
Improve counselling and services to women with communication needs | -Schedule women who need an interpreter to appointments with midwives | x | |||||
-Refer Arabic-speaking women to written information and refer women to websites in different languages | x | x | x | ||||