Client participation and provider communication in family planning counseling: transcript analysis in Kenya

To examine how much and in what ways clients participate in family planning consultations, and how providers influence their behavior, investigators analyzed transcripts of 178 counseling sessions with female clients in Kenya and developed coding guides that focus on client participation. The results show that providers dominate most counseling sessions, and clients rarely take an active role. The most common way for clients to participate is by volunteering additional information when they respond to providers' questions. Providers may encourage clients to play a more active role by building a sense of rapport, by relating contraceptive information specific to each client's personal situation, and by rewarding clients' attempts to participate.