GATHER Step Tell, Population Reports, Series J, Number 48

GATHER Elements:	Greet	Ask	Tell	Help	Explain	Return	Charts	Contents

TELLING—

Tailored & Personalized

In GATHER, T stands for “Tell.” The provider responds to the client’s situation, needs, and concerns. The provider tells the client information that helps the client reach a decision and make an informed choice.

To make wise choices, clients need useful, understandable information. This information should describe the client’s various options and explain possible results. To help with understanding, you can make information both tailored and personalized.

Tailored information is information that helps the client make a specific decision. In the “Ask” step of GATHER, you can learn what decisions the client is facing. Then, in the “Tell” step, you can give specific information that helps the client make those decisions. You can skip information that makes no difference to the client. Information that makes no difference can overload and confuse the client.

Personalized information is information put in terms of the client’s own situation. Personalizing information helps the client understand what the information means to her or him personally. (See example in box below.)

Example—Information for a man deciding how to protect himself against HIV/AIDS:

Good: "Having certain other STDs can raise the changes of getting HIV/AIDS."

Better (tailored): "For a person with more than one sex partner, the best protection against getting STDs during sex is using a condom every time."

Best (tailored & personalized): "You mentioned that you have two girlfriends now. The best way to protect yourself and your girlfriends is using a condom every time you have sex with either of them."

Suggested exercise: Imagine a specific client. Then tailor and personalize an important fact about reproductive health for that client.

Tailoring Information for Method Choice

Family planning clients should have access to full information about all available methods. At the same time, describing every method in equal detail can be confusing to a client trying to choose a method. Here is an easy way to find out what the client needs to know:

1. Ask what method the client wants. Most clients already have a method in mind. In general, clients should get the method they want. They will use it longer and more effectively. Make sure the client (1) understands the method, (2) has no medical reason to avoid it (see chart, Help Clients Choose a Family Planning Method), and (3) knows other methods are available when she or he wants to switch.

2. What if the client cannot use that method? Ask what the client likes about that method, and then describe similar methods. For example, a woman wants an IUD because it is long-acting, very effective, and reversible. But she cannot use an IUD for medical reasons. You can tell her about Norplant implants because implants also are long-acting, very effective, and reversible.

3. What if the client has no method in mind? Ask what is most important to the client about a method. (For example—very effective? convenient? discreet? reversible? no chance of side effects?) The answers help suggest methods that could meet the client’s needs.

Suggested discussion: What are other ways to find out quickly what a client needs to know?

KEY WORDS FOR TELLING
"Do you have a method in mind?"

Most new family planning clients already have a method in mind. The "Tell" step in good counseling about method choice starts with that method.

"And what is it about this method that you like?"

This question helps check whether the client really understands the method. Any mistaken ideas can be gently corrected. Also, the provider can mention other available methods with the same advantages—in case the client does not know these other methods.

Clients should have the method that they want so long as they understand the method and there is no medical reason to avoid it.

Find more ways to tell people about family planning methods. Counseling is important, but providers also can tell people about methods in many other ways—for example, radio, television, newspapers, community and clinic presentations, pamphlets, and wall charts. Clients who know more about methods before counseling can make better decisions during counseling.

Counseling Starts in the Community

Informing the community and counseling clients go hand-in-hand. The better that people can be informed before counseling, the better that counseling can help clients make informed choices that meet their needs.

Why give community talks & hold group discussions?

To inform many people at once. This saves time.
To tell the community about services.
To start people thinking about their choices even before they meet with a health care provider.
To save time during counseling for addressing each client’s needs and helping the client learn instructions.
To answer questions that people are too shy to ask.
To start a continuing discussion in the community.
To create a common understanding among people. This helps avoid rumors.
To make people aware of risky reproductive health behavior and to encourage safer behavior.
To help people share their experiences and support each other’s healthy decisions.

When & where?

When community groups meet.
At workplaces and schools.
At specially planned public gatherings.
At other public events such as sports matches, fairs, exhibitions.
While clients wait in clinics.

Tips for talks & discussions

Find out in advance who the audience will be, what they know, and what they want to know.
Prepare. Know your goals, main points, and a few discussion questions. Plan your time.
To begin, introduce yourself and the topic.
Help people feel at ease. In a small group, you could start a short game or ask people to introduce themselves.
Start discussion with clear, simple information.
Use words that everyone understands.
Use audiovisual materials (see Tips on Using Audiovisual Materials), including sample contraceptives if appropriate.
Help keep discussion going. Keep eye contact. Encourage people to comment and ask questions. Ask “what” and “how” questions in a respectful way.
Invite people to talk about their own experiences.
If discussion strays from the topic, gently lead it back with an appropriate question.
Summarize important points during the discussion and again at the end.
At the end, suggest one important action that every person there can take—for example, each person can tell one other person in the community something important that they have learned.

Suggested discussion: List groups and places where presentations and discussions could take place. Discuss how to contact these groups, prepare presentations and discussions, and carry them out.

Effectiveness of Family Planning Methods
This table shows how many women in every 100 women become pregnant during the first 12 months of using major family planning methods. Two rates are shown for each method. The rate shown under "As Commonly Used" is a typical, or average rate. Some couples do better than this, and others do worse. The rate under "Used Correctly & Consistently" applies to couples who follow the use instructions exactly and make no mistakes.

Family Planning Method Pregnancies per 100 Women
in First 12 Months of Use

As Commonly Used Used Correctly and Consistently

Norplant implants Less than 1⁺ Less than 1⁺

Vasectomy Less than 1⁺ Less than 1⁺

DMPA and NET EN injectables Less than 1⁺ Less than 1⁺

Female sterilization Less than 1⁺ Less than 1⁺

TCu-380A IUD Less than 1⁺ Less than 1⁺

Progestin-only oral contraceptives during breastfeeding 1⁺ Less than 1⁺

LAM (for 6 months only) 2^† Less than 1⁺

Combined oral contraceptives 6–8^† Less than 1⁺

Condoms 14^‡ 3^†

Diaphragm with spermicide 20^‡ 6^†

Fertility awareness-based abstinence 20^‡ 1–9^†

Female condoms 21^‡ 5^†

Spermicides 26^‡ 6^†

No method 85 85

Key to colors in table:
⁺ Green = Very effective (0–1)
^† Blue = Effective (2–9)
^‡ Yellow = Somewhat effective (10–30)
For sources and further explanation, see Hatcher et al., The Essentials of Contraceptive Technology, Johns Hopkins Population Information Program, 1997, pages 4—18 and 4—19.

GATHER Elements: Greet Ask Tell Help Explain Return Charts Contents

*Effectiveness of Family Planning Methods* This table shows how many women in every 100 women become pregnant during the first 12 months of using major family planning methods. Two rates are shown for each method. The rate shown under "As Commonly Used" is a typical, or average rate. Some couples do better than this, and others do worse. The rate under "Used Correctly & Consistently" applies to couples who follow the use instructions exactly and make no mistakes.
Family Planning Method	Pregnancies per 100 Women in First 12 Months of Use
As Commonly Used	Used Correctly and Consistently
Norplant implants	Less than 1⁺	Less than 1⁺
Vasectomy	Less than 1⁺	Less than 1⁺
DMPA and NET EN injectables	Less than 1⁺	Less than 1⁺
Female sterilization	Less than 1⁺	Less than 1⁺
TCu-380A IUD	Less than 1⁺	Less than 1⁺
Progestin-only oral contraceptives during breastfeeding	1⁺	Less than 1⁺
LAM (for 6 months only)	2^†	Less than 1⁺
Combined oral contraceptives	6–8^†	Less than 1⁺
Condoms	14^‡	3^†
Diaphragm with spermicide	20^‡	6^†
Fertility awareness-based abstinence	20^‡	1–9^†
Female condoms	21^‡	5^†
Spermicides	26^‡	6^†
No method	85	85
Key to colors in table: ⁺ Green = Very effective (0–1) ^† Blue = Effective (2–9) ^‡ Yellow = Somewhat effective (10–30) For sources and further explanation, see Hatcher et al., *The Essentials of Contraceptive Technology*, Johns Hopkins Population Information Program, 1997, pages 4—18 and 4—19.

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