Contraceptive counseling in 2 urban cities in Ghana and the extent of shared decision-making
Abstract
BACKGROUND Increased use of contraception is associated with reduced maternal mortality worldwide; however, an unmet need remains high in many places, including Ghana. The quality of care provided by family planning practitioners influences contraceptive use; one way to improve the quality of care is to adopt a client-centered approach to counseling, including engaging in shared decision-making. In Ghana, little is currently known about the extent of shared decision-making between clients and providers in contraceptive counseling encounters. OBJECTIVE The purpose of this study was to explore the extent of shared decision-making during contraceptive counseling in 2 cities in Ghana. STUDY DESIGN This was a cross-sectional study across 6 urban family planning clinics in Accra and Kumasi, Ghana. We recorded, transcribed, and analyzed 20 family planning patient-provider interactions using the “Observing PatienT InvOlvemeNt" (OPTION) scale. This scale has 12 domains, which are scored on a 5-point scale, from 0 (“the behavior is not observed”) to 4 (“the behavior is observed and executed at a high standard”); the scores of each domain are summed up for a total score ranging from 0 to 48. RESULTS In these encounters, the mean total scores for each interaction ranged from a low of 9.25/48 to a high of 21.5/48. Although providers were thorough in sharing medical information with clients, they did not actively involve clients in the decision-making process and did not generally elicit…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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