Supporting Providers with Job Aids

Job aids can help providers meet the extra demands placed on them in offering integrated services for young people. Research shows that job aids work in three ways to improve the performance of health care providers—and, in turn, the quality of care—each of which becomes more important when providers have to master multiple services (18).

First, job aids can supply technical information needed during consultations. Having reference information reduces the burden placed on providers’ memories when integrated programs ask them to offer additional services. For example, consulting a checklist of medical eligibility requirements for a contraceptive method can ensure that providers do not overlook any safety issues or confuse requirements for different methods. Such a checklist could be especially helpful for providers from HIV/AIDS programs who are integrating family planning into HIV counseling, testing, and treatment.

Second, job aids can prompt providers what to do next during consultations. Cues and reminders can help providers conduct a consultation in a complete and orderly fashion, even when offering multiple, integrated services. For example, an integrated counseling protocol that outlines what providers should do, step-by-step, can ensure that providers systematically assess and address the full range of a young client’s reproductive health needs, rather than focusing solely on the service requested by the client.

Third, job aids can guide and support the decision-making process. Decision aids help providers make good judgments, even as integrating services increases the number and types of health problems they must deal with. For example, an STI algorithm or flowchart can guide providers to the correct diagnosis and choice of treatment when a client shows symptoms of infection. Such an algorithm could help maintain good quality of care when family planning providers are asked to begin managing STIs.

The job aids described here can help providers accomplish the wide range of tasks that form part of integrated services, from coaching youth on how to refuse sex to diagnosing an STI.To determine which job aids might benefit their programs, managers should consider the following questions:

• What tasks do providers perform incorrectly, inconsistently, or have trouble integrating together?
• What aspects of the task are most challenging for providers?
• What could help providers perform these tasks better and integrate them together more smoothly? Could they benefit from instructions, reminders, a decision tree, or an easy-toconsult digest of technical information?

Model job aids. The resources below contain a variety of job aids for providers, while managers also may find some portions useful.The job aids range from simple checklists and fact sheets to complex protocols and lengthy manuals. Most supply technical information, counseling guidance, or some combination of the two. All are potentially useful for programs delivering integrated services, either because they address a variety of services or because they link those services together.

Barnett, B. and Schueller, J. Meeting the needs of young clients: A guide to providing reproductive health services to adolescents. Research Triangle Park, NC, FHI, 2000.

This counseling guide focuses on preventing pregnancy and STIs, including HIV/AIDS. It also contains a section on counseling victims of sexual violence.The guide offers tips on how providers can discuss reproductive health and family planning issues with young people, as well covering technical information on contraception and infections.The sections on youth-friendly services and referral networks are useful for program managers.The guide is available in English, French, and Spanish.

Available at: http://www.fhi.org/en/RH/Pubs/servdelivery/adolguide/index.htm
For print copies: Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709. Tel: 919-544-7040. Fax: 919-544-7261. E-mail: publications@fhi.org. POPLINE® Document Delivery Service: order number 153943

Fischer,S.,Reynolds,H;,Yacobsen, I;Schueller, J;and Barnett B. HIV counseling and testing for youth: A manual for providers. Arlington, VA: Family Health International, YouthNet Program, 2005.

Developed with the help of Kenyan youth counselors, this manual serves both as a counseling guide and a reference tool for providers who focus on HIV counseling and testing. It is designed to help integrate other health services, including family planning, into counseling for young people.The manual assumes that providers already understand the technical aspects of administering HIV tests and focuses instead on youth-friendly counseling.To help providers link HIV testing with other reproductive health and family planning services, the manual discusses the prevention of pregnancy and other STIs, introduces the concept of life skills, and supplies a form to record local referral resources and their contact information.

Available at: http://www.fhi.org/en/Youth/YouthNet/rhtrainmat/vctmanual.htm
For print copies: Family Health International,YouthNet Program, 2101 Wilson Blvd, Suite 700, Arlington,VA 22201 USA.Tel: 703-516-9779. Fax: 703-516-9781. E-mail: aidspubs@fhi.org. POPLINE® Document Delivery Service: order number 291242

Yacobson, I. Contraception for women and couples with HIV. Family Health International and ACQUIRE, 2005.

As the incidence of HIV infection among young people rises, providers are increasingly likely to work with young clients living with HIV/AIDS.While not specifically tailored to young people, this electronic counseling guide can help providers advise youth living with HIV about their contraceptive options. It reviews the reproductive choices facing individuals and couples with HIV, outlines how to integrate family planning with HIV services, and makes contraceptive recommendations for women infected with HIV, with full-blown AIDS, and/or on antiretroviral (ARV) therapy.Where computers are available, individual providers can access the module, either online or on CD-ROM, for an interactive self-study program.The module also can be used for group presentations.

Available at: http://www.fhi.org/en/RH/Training/trainmat/ARVmodule.htm
For copies on CD-ROM: Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709. Tel: 919-544-7040. Fax: 919-544-7261. E-mail: aidspubs@fhi.org.

Young, A., Shalwitz, J., Pollock, S., and Simmons, M. Sexual health: An adolescent provider toolkit. San Francisco, CA, Adolescent Health Working Group, 2003.

This compendium of assessment and counseling tools, reference materials, and health education information is part of a broader guide to treating teenage patients. It includes job aids that can help providers take a sexual history, talk about safer sex, screen for and treat STIs, and counsel young people on HIV and pregnancy tests.There are reference materials on adolescent development, emergency contraception, STI lab tests, and STI treatment guidelines.

Available at: http://www.go2itech.org/pdf/p06-db/db-50901.pdf
For print copies: Adolescent Health Working Group, 323 Geary Street, Suite 418, San Francisco, CA 94102. Tel: 415-576-1170 x301. Fax: 415-576-1286. E-mail: info@ahwg.net.

Ministry of Health (Jamaica), Youth.now, and UNICEF. Adolescent sexual decision-making counselling protocol. Jamaica, Ministry of Health, 2004.

This protocol, developed by the Youth.now project in Jamaica, guides counselors through a structured, one-hour session that takes an integrated approach to reproductive health counseling.The goals of the session are, first, to help young clients develop a personal risk reduction plan, for example, by deciding to abstain from sex or limit their number of partners; second, to strengthen the negotiation, refusal, and problem-solving skills young people need to put that risk reduction plan into practice; and, third, to provide referrals for STI treatment, HIV counseling and testing, sexual abuse, and family planning services. Detailed instructions and background materials orient counselors to adolescent development, decision-making by young people, and communication skills.

Available at: http://pdf.dec.org/pdf_docs/PNADC076.pdf
POPLINE® Document Delivery Service: order number 286113

Both the counseling tools and media materials developed by the Youth.now project in Jamaica promote the same message: responsible decision making by young people.