Family Planning Competency-Based Training

1 Family PlanningCompetency-Based TrainingBasic Course Handbookfor Service ProvidersTABLE OF CONTENTSA cronymsForewordAcknowledgementsTechnical Working GroupIntroductionSchedule of ActivitiesModule 1: The Philippine Family Planning ProgramSession 1: Overview of the Family Planning ProgramSession 2: Family Planning and Reproductive HealthSession 3: Maternal High-Risk FactorsSession 4: Health Benefits of Family PlanningModule 2: Human Reproductive Anatomy and Physiology - 1: The Female Reproductive SystemSession 2: The Male Reproductive SystemSession 3: The Concept of Fertility and Joint FertilityModule 3: FP Client AssessmentSession 1: The FP Service Record or FP Form 1 in Client AssessmentSession 2: WHO Medical Eligibility Criteria for Contraceptive UseModule 4: Infection Prevention in Family Planning ServicesSession 1: The Disease Transmission Cycle and Infection Prevention Definitions and TermsSession 2: Infection Prevention MeasuresModule 5: Fertility Awareness-Based Methods and Lactational Amenorrhea MethodSession 1: Fertility-Awareness Based methodsSession 2: Lactational Amenorrhea Method (LAM)Module 6: Hormonal Contraceptive MethodsSession 1: Low-Dose Combined Oral Contraceptives (Low-Dose COCs)Session 2: Other Combined ContraceptivesSession 3: Progestin-only Pills (POPs)Session 4: Progestin-only Injectables (POIs)Module 7: Male CondomSession 1: Male CondomModule 8: Long Acting and Permanent MethodsSession 1: Intrauterine DeviceSession 2: Permanent MethodsModule 9: FP for Special 10: Counseling for Family PlanningSession 1: Values ClarificationSession 2: Informed Choice and VoluntarismSession 3 Types of Communication in FP/RHSession 4: Effective Communication SkillsSession 5: Steps in Counseling Using the GATHER ApproachModule 11: Management of Family Planning Clinic ServicesSession 1.

2 Managing for QualitySession 2: Facility-Based FP ServicesSession 3: Management Support SystemsSession 4: Monitoring and EvaluationSession 5: Service Delivery NetworkModule 12: Action Immune Deficiency SyndromeAO Administrative OrderAOGAge of GestationARH Adolescent Reproductive HealthARMM Autonomous Region of Muslim MindanaoARVA ntiretroviral DrugsASC Ambulatory Surgical ClinicASL Authorized Stock LevelBBT Basal Body TemperatureBHW Barangay Health WorkerBHS Barangay Health StationBIP Basic Infertile PatternBMD Bone Mass DensityBMI Body Mass IndexBOM Billings Ovulation MethodBP Blood PressureBTL Bilateral Tubal LigationBSPO Barangay Supply Point OfficerCBHCO Community-based Health Care OrganizationCBMIS Community-based Monitoring Information SystemCBT Competency-Based TrainingCDLMISC ontraceptive Distribution Logistics Management Information SystemCHD Center for Health Development (formerly Regional Health Office)

3 CHO City Health OfficeCIC Combined Injectable ContraceptiveCO Central OfficeCOC Combined Oral ContraceptiveCOF Contraceptive Order FormCON CondomCPR Contraceptive Prevalence RateCPS Contraceptive Prevalence SurveyCR Cardiac RateCSR Contraceptive Self-RelianceDMPA Depot Medroxyprogesterone AcetateDOH Department of HealthDSWD Department of Social Welfare and DevelopmentDTUR Dispensed To User RecordDVT/PE Deep Vein Thrombosis/Pulmonary EmbolismEDR Early Days RuleEE Ethinyl EstradiolFAB Fertility Awareness-Based MethodFEFOF irst-to-expire, First-outFHSIS Field Health Services Information SystemFP Family PlanningiIntroductionFPSF amily Planning SurveyFSHF ollicle-Stimulating HormoneHBVH epatitis B VirusHCGH uman Chorionic GonadotropinHHHouseholdHIVH uman Immunodeficiency VirusHLDHigh Level DisinfectionHMOH ealth Maintenance OrganizationHPVH uman Papillomavirus ICPD International Conference on Population and DevelopmentICVI nformed Choice and VoluntarismIE Internal ExaminationIEC Information, Education, and CommunicationILHZ Interlocal Health ZoneIM IntramuscularIMAP Integrated Midwives Association of the PhilippinesIUD Intrauterine DeviceIUS Intrauterine SystemLAM Lactational Amenorrhea MethodLAPMLong-Acting Permanent MethodsLCEL ocal Chief ExecutiveLGU Local Government UnitLHLuteinizing HormoneLMPLast Menstrual PeriodLNGL evonorgestrelMNCHN Maternal, Newborn.

4 And Child Health and NutritionMCP Maternity Care PackageMDG Millennium Development GoalsMEC Medical Eligibility CriteriaMIS Management Information SystemMOA Memorandum of AgreementMTPDP Medium-Term Philippine Development PlanMWRAM arried Women of Reproductive AgeNDHS National Demographic and Health SurveyNDS National Demographic SurveyNEDA National Economic Development AuthorityNET-ENNorethisterone EnantateNFP Natural Family PlanningNGA National Government AgencyNGONon-Government OrganizationNOH National Objectives for HealthNSD Normal Spontaneous DeliveryNSV No-Scalpel VasectomyOB-GYNEO bstetrics-GynecologyOC Oral ContraceptiveiiIntroductionPE Physical ExaminationPGR Population Growth RatePFPP Philippine Family Planning ProgramPHICP hilippine Health Insurance Corporation (PhilHealth)PHO Provincial Health OfficePID Pelvic Inflammatory DiseasePLGM Philippine League of Government MidwivesPMAC Prevention and Management of Abortion and its ComplicationsPMPP revious Menstrual PeriodPNDF Philippine National Drug FormularyPOCP rogestin-only ContraceptivePOI Progestin-only InjectablePOP Progestin-only PillPOPCOMP opulation CommissionPOPDEV Population and DevelopmentPPO Provincial Population OfficePR Pulse RatePRC Professional Regulation CommissionPRE Population, Resources.

5 And EnvironmentPROM Premature Rupture of MembranesRH Reproductive HealthRHU Rural Health UnitRIV Requisition and Issue VoucherRPFS Republic of the Philippines Fertility SurveyRTI Reproductive Tract InfectionsRUV Relative Unit ValueSDM Standard Days MethodSTI Sexually Transmitted InfectionsSTMS ympto-thermal MethodTCL Target Client ListTDM Two-Day MethodTFR Total Fertility RateTNA Training Needs AssessmentTWG Technical Working GroupUSAID United States Agency for International DevelopmentVAWC Violence Against Women and ChildrenVSC Voluntary Surgical ContraceptionWCPUW omen and Child Protection UnitWHO World Health OrganizationiiiIntroductionivIntroductio nFOREWORDThe Department of Health (DOH) has consistently improved Training for health service providersto enhance their capabilities to deliver quality Family Planning (FP) services. In line with thiscommitment to achieve continuing quality improvement, the DOH together with partner agenciesreviewed and updated the Family Planning Competency Based Training (FPCBT) Modules tokeep pace with the new trends and developments in Family revised version of the FPCBT Manual is aligned with the 2006 FP Clinical Standards Manualand is consistent with current developments in responsible parenting policies.

6 It adopts moderntraining approaches towards further enhancing the knowledge, skills, and attitude of overall objective of the Training manual is to enable health service providers to safely administerand dispense FP services to, and share accurate information on the different modern FP methodswith clients. It aims to improve the quality of FP services delivered by providers in both public,non-government organizations, and private health facilities. It contains up-to-date FP informationdrawn from actual experiences of Family Planning experts, and backed up by evidence-basedmedical information and effective FP practices recommended by highly credible internationalreferences, particularly the Medical Eligibility Criteria (MEC) for Contraceptive Use and SelectedPractice Recommendations (SPR) of the World Health revised manual introduces an integrated, streamlined, and performance-based Training designthat builds on the motivation and commitment of the frontline service providers.

7 The DOH hopesthat all health service providers undergo the FPCBT to ensure the delivery of FP services that areconsistent with and supportive of the country s commitments to the Millennium Development Goalsand the Philippine Development strongly encourage the effective dissemination and utilization of this manual across the countryas one of the tools towards achieving improved quality of health T. ONA, MD, FPCS, FACSS ecretary of HealthvIntroductionACKNOWLEDGEMENTSThe DOH recognizes and expresses its full appreciation to all those who participated in thedevelopment, revision, pre-testing, final review, and editing of the particular, the DOH would like to thank the following: The United States Agency for International Development (USAID) in providing technicalassistance in the overall process of developing the manual. The Technical Working Group whose members came from various sectors and agencies,who not only unselfishly shared their technical expertise and experiences but also tooktime out of their busy schedules and concurrent work to enhance, pretest, edit, and finalizethe Training manual.

8 The individuals who were contracted for the development, pre-test, design, and layout ofthe manual. The FP trainers from the different CHDs and Local Government Units who providedtechnical inputs and insights and shared their experiences in conducting Training activitiesat the local level. These FP trainers also served as facilitators during the pre-testing togetherwith a group of health service DOH is also grateful to those who contributed in one way or another in producing this trainingmanual but whose names have not been V. BAYUGO, MD, MPH, CESO IIIOIC, Undersecretary of HealthPolicy, Standards Development and Regulationand Health Sector Financing ClustersviIntroductionTECHNICAL WORKING GROUPC hairperson:Dir. Honorata L. Catibog, DOH-NCDPC-FHOM embers:Dr. Lourdes Paulino, NCDPC-FHODr. Florence Apale, NCDPC-FHOMs. Carole Bandahala, NCDPC-FHODr. Consuelo Aranas, HealthGovDr. Rosario Marilyn Benabaye, HealthGovDr.

9 Cesar Maglaya, HealthGovDr. Cynthia Garcia, PRISM1Dr. Esmeraldo Ilem, Jose Fabella HospitalMs. Erlinda Villagarcia, Jose Fabella HospitalMs. Lety Daga, IMCCSDIMs. Elizabeth Valles, WFMFIMs. Evelyn Lleno, DOH-HHRDBMr. Lydio Espanol, HealthPRODr. Eduardo Tandingan, SHIELDDr. Ellen Bautista, SHIELDDr. Hendry Plaza, UNFPADr. Jocelyn Ilagan, HPDPMs. Mitos Rivera, IRH PhilippinesMs. Gladys Malayang, HDIIDr. Jose Narciso Sescon, HDIIT echnical Support and Secretariat:Ms. Onofria de Guzman, NCDPC-FHOMr. Arnold Vega, HDIIMs. Cyril Dalusong, HDIIT echnical Reviewer:Dr. Ricardo B. GonzalesDesign and Lay-out: Toolbox Creatives Design, integrated, modified Family Planning Training system is performance-based which developsthe knowledge, attitudes, and skills of participants on the requirements of quality FP serviceprovision. The Training system implements a basic approach that exposes participants to levelsof Training based on certain criteria which qualify them to the next higher level of higher level Training course will develop more specialized skills in the intrauterine device, bilateraltubal ligation by minilap under local anesthesia and no scalpel vasectomy, and provision of naturalfamily Planning .

10 Participants to this level of Training must be professionally qualified to performthe skills taught in the respective course, have undergone the basic course, have satisfactorilyintegrated the skills learned in their provision of health services, and have the ability and opportunityto increase the client load for the service(s) they will be trained support of this Training system and as a response to the request from the regional and provincialprogram managers and private health practitioners, HealthGov, PRISM, HPDP, SHIELD, IRHP,Dr. Jose Fabella Memorial Hospital and selected trainers from the CHDs provided technicalassistance to DOH-NCDPC in revising the Training materials. The revision will strengthen thetraining system and improve service provider performance ensuring high quality of Family DOH-NCDPC assisted by HealthGov and other USAID Cooperating Agencies conducted twoconsultative workshops which were the initial activities in the revision of the Training paved the way to the development of the 2010 FPCBT Basic Course Handbook.