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.
- 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.
- 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.
- Evaluate the impact of SDM services in the short-
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
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: