Most countries have national guidelines and standards to guide family planning service delivery. These extensive resources (see examples from Kenya and Nigeria) often cover the characteristics and benefits of different contraceptive methods and how they should be delivered to clients to ensure high-quality services.

As such, these guidelines inform core competencies and performance standards for family planning service providers and are integral to program functions such as pre-service education, in-service training, supportive supervision, clinical coaching, self-directed and peer-to-peer learning and training follow-up.

These guidelines are periodically updated, so make sure you are using the latest version.

Check to see if any job aids have been developed and disseminated to providers to help them use the guidelines and standards. If there are performance gaps, assist the local clinical service site to obtain, understand and use the guidelines and standards documents and job aids. You may need to conduct training and/or coaching.

Most providers will likely have a basic level of family planning knowledge and skills through previous pre-service and/or in-service training. However, all will need to acquire new knowledge or refresh existing knowledge and improve their skills in order to expand and scale up family planning services in TCI’s urban, underserved geographies.

Depending on the learning needs of participants, this initial or refresher training can be delivered through various learning modalities, ranging from a simple orientation to TCI workshop to a full training workshop and/or coaching to refresh and strengthen their family planning knowledge and skills.

Before conducting any training activities, you should conduct a training assessment to help determine the content and scope of the training required. Training should always follow your country’s national service protocols.

On-the-job training, whereby knowledge and skills are gained at the providers’ place of work, is an alternative option to classroom-based training.

Refresher training should always be considered, whether it is revisiting materials from a prior training or building on previously gained skills. This can take place in-person, through an online learning system (such as TCI University) or even through a mobile application.

Providers should always be given opportunities to improve, further develop and enrich their skills because they can be powerful motivating factors for improving service quality.

Regardless of which contraceptive methods providers are authorized to provide, which will vary by country, all family planning service providers should perform the following core competencies according to standards.

Provide Client-Centered Care that Respects Informed Choice and Voluntarism

Skilled service providers need to be competent in providing client-centered care that respects informed choice and voluntarism throughout the entire client-provider interaction, whether it be in a facility, in a community or through mobile-based service. As programs work toward reducing unmet need for family planning, they have a duty, in particular, to protect the human rights of women and men as they develop, implement, monitor and evaluate programs (see related WHO guidance and recommendations as well as a practical conceptual framework to help operationalize these principles in programs). Training and performance standards for client-centered care include:

• Establishing and maintaining rapport with the client
• Approaching all clients, including marginalized and vulnerable populations, in a nonjudgmental and nondiscriminatory manner with respect for individual dignity
• Ensuring privacy and confidentially both verbally and visually
• Showing respect for clients’ choices, as well as their right to consent for or refuse care
• Listening actively to clients and encouraging their questions
• Tailoring the client-provider interaction to the individual client’s needs and preferences
• Addressing the special needs of populations such as adolescents, young adults and men.

(These core competencies for client-centered care have been adapted from multiple sources including the U.S. Department of Health and Human Services and K4Health.)

After training, skilled providers need performance support on-the-job in order to transfer their learning to the workplace and continuously perform according to guidelines, standards and client’s expectations of quality. This can be accomplished best through supportive supervision. Supportive supervision encourages open, two-way communication that facilitates problem-solving, continued learning and teamwork, as opposed to traditional, hierarchical models of supervision.

It is an ongoing process that aims to strengthen the relationship between the supervisor and supervisee so that performance can be continuously monitored and problems or other performance issues can be quickly identified and resolved (see box below). National and institutional family planning programs often develop tools such as supervisory checklists, reporting forms and schedules; self-assessment and peer-to-peer checklists; and continued learning/performance improvement action plans to support the supportive supervision process.

It is also important to maintain a favorable work environment for the provider, which can be supported by management tools such as consultation registers, client forms, and appointment cards. Communication support can also help, such as films on counseling, images, presentations, posters, brochures, and tables for supervision.