SDM Implementation Guidelines

Assuring Quality

Most service delivery programs have established mechanisms for monitoring the quality of services. These may include supervision visits, review of service statistics, routine observations and feedback to staff, and special studies such as client exit interviews and mystery clients. While planning introduction of SDM services, it is important to identify what programs will do to assure that high quality services are provided.

Key Actions

  1. Integrate the SDM into existing supervision systems
    At the service delivery level, supervisors should include the SDM in the routinely scheduled supervision visits. A Knowledge Improvement tool (KIT) for the SDM is available to help supervisors assess counselors skills and knowledge, and identify needs for remediation. The KIT consists of a series of questions that providers are asked about the SDM. It reinforces knowledge and provides immediate, individualized feedback during follow-up or supervisory visits.
  2. Integrate the SDM into the existing MIS
    Most organizations have management information systems that collect basic service statistics on programs and clients. The SDM should be incorporated into this system, and all relevant data collection forms should include the SDM. This will allow the program to collect data about users and evaluate acceptance of the method and results of outreach and information efforts. Information provided by the MIS may also determine the profile of SDM users, and determine if clients are new or previous users of family planning. This data will also help programs measure the effectiveness of services in different clinics and identify areas that need strengthening.
  3. Evaluate the impact of SDM services in the short- and long-term
    It is recommended that an internal evaluation of the introduction of SDM be conducted. This will enable program planners to identify the strengths and weaknesses of the program, consider lessons learned, and adapt and adjust strategies as appropriate—taking into consideration the perspective of service providers as well as actual SDM users. A longer-term impact study might also be considered to examine the effect of SDM introduction on method mix and contraceptive prevalence.

    The Knowledge Improvement Tool

    A Knowledge Improvement Tool (KIT) was developed by IRH to help maintain and improve provider competence in SDM counseling. The KIT, a checklist of required SDM provider behaviors, identifies individual provider deficits that need to be corrected. It is meant to be used by a supervisor during regular supervisory visits but it can also be used by the provider as a self-applied checklist Use of the KIT can help strengthen provider competency, and it offers a more cost-effective and timely alternative to refresher training. In India, El Salvador and Honduras, use of the KIT checklists resulted in significant improvements in provider ability from an overall score of 67% one month after training to 87% after one year of service delivery.

Key Supervision and Monitoring Materials:

Copyright 2006 Institute for Reproductive Health