Why is informed decision making for sexual and reproductive health clients Important?

Cordaid is committed to improving the sexual and reproductive health of women and men and strengthening implementation of SRH services. Cordaid believes that everybody has the right to respectful sexuality. Informed decision-making can make an important contribution to respectful sexuality. With adequate and appropriate information, individuals and couples can take responsibility for and make decisions related to the sexual and reproductive aspects of their lives.

What sexual and reproductive health servIces should clients have access to?

HIV & AIDS Antenatal Family Planning Post-partum & post-abortion STI/RTI Maternal & newborn health

These services are all interlinked and can be provided by government, FBOs, NGOs or the private sector. Not all service providers provide this comprehensive range. But regardless of the type of service provided understanding the needs of clients and making effective referrals should ensure that clients can access all the information and services that they need.

A guide for partner organisations providing sexual and reproductive health services

Informed decIsIon makIng

For more information on: Informed decision making Cordaids policy Country profiles for sexual and reproductive health service standards

Visit www.cordaidpartners.com Contact Geertje van Mensfoort: Email: gen@cordaid.nl t +31-(0)70 3136536 f +31-(0)70 3136511 www.cordaid.nl

What Is informed decision making in sexual and reproductive health?

When a person makes an informed decision about their sexual and reproductive health (SRH), they make a choice which is voluntary, well-considered, and based on options, information and understanding. Sexual and reproductive health services should help people have a responsible, satisfying and safer sex life. This includes the freedom to decide if, when and how often to have children.

key elements of facilitating informed decision making are services available?

What affects peoples ability to make informed decisions?

What do sexual and reproductive health service providers need to ensure?

Artificial contraceptives are not provided by a service Interruption in the supply of condoms and other contraceptive devices Limited clinic hours Ineffective referral systems to other services Young people and unmarried people are excluded from services

Effective referrals are essential: coordination between service providers will help clients access a range of services more flexibly on an ongoing basis. Networking with other services can help providers manage unexpected supply interruptions by creating additional temporary referral routes. Translators or bi-lingual staff are available. Clients are supported to make decisions without pressure from others. Staff respect clients decisions and remain non-judgmental.

is decision of the client voluntary?

Limited time available to see each client Expectations of women to seek permission from husband or other family member to make decisions Staff are not objective about services and/or clients Lack of basic written information materials and examples of methods to show clients Staff do not have enough training and confidence Personal views about morality prevent some staff from discussing condoms and other contraception options Language barriers Lack of private counselling spaces Lack of trained and experience staff to discuss intimate issues with clients who find sex difficult to discuss openly Personal views of staff about morality and behaviour affect their communication styles

do clients have the information they need?

Written and illustrative materials, as well as examples of family planning commodities,are available to clients. Staff are trained and confident to explain artificial and natural contraception. Staff remain objective about service options, clients and their decisions. Staff have support and training to develop their communication skills. They remain objective; listen to clients; encourage clients to ask questions; provide answers in easily understood language; and ensure confidentiality and privacy. Services have adequate staffing levels so that they have the capacity to meet the clients needs. Service providers have clear policies and guidelines for staff on informed decision making to promote and facilitate peoples ability to make decisions. Service provision is designed to ensure it is not undermined by external factors which affect peoples ability to make decisions.

is communication good between service provider and client?

What does informed decision making Include?

Facilitating informed decision making means helping clients choose the available sexual and reproductive health services that they decide are most appropriate for their needs. The process of making an informed decision has five key elements: the table opposite lists these crucial factors and explains some of the barriers to clients ability to make informed decisions, and how service providers can ensure that they facilitate clients decision making.

does the external environment supports individuals decision making?

Church, donor and government policies prohibit some services, or services for some clients Gender inequality and the low social status of women