Part II: Guidelines for Client Services and Clinic Management
- 9.1 Gynecologic Services
- 9.2 Sexually Transmitted Diseases (STDs) and HIV/AIDS
- 9.3 Special Counseling
- 9.4 Genetic Information and Referral
- 9.5 Health Promotion and Disease Prevention
- 9.6 Postpartum Care
The following family planning related services, which can improve quality of care, may be offered if skilled personnel, equipment and funding are available.
9.1 Gynecologic Services
Family planning should provide for the diagnosis and treatment of minor gynecologic problems so as to avoid fragmentation or lack of health care for clients with these conditions.
Immediate clinical diagnosis and treatment should include:
- Urinary tract infections
More complex procedures may be offered to family planning clients, provided that clinicians performing these services have specialized training.
9.2 Sexually Transmitted Diseases (STDs) and HIV/AIDS
Refer to Section 8.2 and 8.3 for STD and HIV/AIDS counseling and testing requirements. STD diagnosis and treatment, and HIV/AIDS testing beyond the scope of Program requirements may be offered if personnel and funding are available.
9.3 Special Counseling
Clients should be offered appropriate counseling and referral, as indicated, regarding future pregnancies, the management of a current pregnancy, and other individual concerns (e.g. substance use and abuse, family and intimate partner violence,
genetic issues, nutrition, sexual concerns, etc.).
9.3a Preconception Education
See Section 8.2 for required basic preconception education for all clients. Advanced level preconception counseling should be provided if the client's history indicates a desired pregnancy in the future. At the client's request, a health risk
appraisal should be provided to help promote a healthy future pregnancy. Appraisal forms and educational materials must be in place if this service is offered. If a delegate agency has an IDHS approved preconception counseling protocol, they may be
reimbursed for this counseling service.
9.3b Nutritional Counseling
Nutritional counseling should include problem identification, basic nutritional information, screening and medical care to clients at high risk of nutrition problems or those requiring nutritional management of disease. All women of childbearing age
will be educated on folic acid intake in prevention of neutral tube defects in the infant. Each client having a low hematocrit/hemoglobin should be interviewed to determine if the cause could be a nutritional deficiency. Information on dietary source of
iron should be given as appropriate. If indicated, follow-up testing for anemia must be provided.
9.3c Substance Use and Abuse
The health history should include assessment for substance use and abuse. Referral for substance abuse evaluation must be provided if indicated by the client's history.
9.3d Male Counseling
Provision of any services to males (e.g. supply pick-up, sterilization counseling, individual or couple education) presents the opportunity to provide education on the following:
- Proper use of condoms
- STD and HIV risk
- Testicular self exam (TSE) and breast self exam (BSE)
- Health relationships
- Family and partner abuse
- Supporting partner health (fertility awareness, female breast self exam)
- Sexual concerns
9.3e Family and Intimate Partner Violence
The health history should include key assessment questions to identify intimate partner or family violence. Referral for further evaluation, shelter, or support must be provided if indicated by the client's history.
Refer to Appendix N for an intervention resource for intimate partner violence.
9.4 Genetic Information and Referral
Extensive genetic counseling and evaluation is beyond the scope of the DHS family planning program. However, basic information regarding genetic conditions and referral should be offered to clients who request it or to those who are in need of such
services. Some delegates may be located in or near local health departments with genetic nurse educators available. The Illinois Department of Public Health may be contacted for the nearest genetic services.
Initial genetic screening consists of a careful family history of the client and the client's partner.
- More complete screening and counseling may be offered directly (by a genetic counselor who functions in association with clinical genetics team capable of providing comprehensive services) or indirectly (through referral to a comprehensive genetic
- Linkages should be established with a comprehensive genetic service program for client referral.
In-service training in genetics should be arranged for project staff to enable them to provide basic genetic information.
Literature and informational materials regarding the availability of genetic services, including but not limited to prenatal diagnosis, should be available in the appropriate language to all clients on request. Information on IDPH's statewide genetic
screening program should be available to all clients.
9.5 Health Promotion and Disease Prevention
For many clients, family planning programs are their only continuing source of health information and medical care. Projects should, therefore, assess the health problems prevalent among their service population and develop strategies to address these
problems. Projects should, whenever possible, provide or coordinate access to services intended to promote health and prevent disease. Refer to Section 8.0 Required Services.
9.6 Postpartum Care
Family planning programs may provide postpartum care in collaboration with local agencies or institutions that provide prenatal and/or intrapartum care.
If a family planning program assumes responsibility for postpartum care, then they should include the following:
- Assessment of the woman's physical health
- Initiation of contraception
- Postpartum depression education and screening. Special attention should be given to assessment of and referral for depression.
If time and staff skills permit, also include the following:
- Counseling and education about parenting
- Breastfeeding and resources for support
- Infant care anticipatory guidance
- Family adjustment