Gems are management tools and processes developed by the Family Planning Management Development project in partnership with the staff of their client organizations to strengthen the management of health and family planning programs and organizations around the world.
Description of This Tool
This tool is designed to help managers determine whether skipped appointments are a problem and identify the reasons why clients fail to return to a service delivery site when expected. With this information, service delivery site managers can take actions that will help to reduce the percentage of clients who fail to return for needed visits.
Potential Uses
As presented, this tool can be used to identify the service delivery sites that have low no-show rates and those that have high no-show rates. By analyzing data about no-show clients and communicating with the sites, program managers and supervisors can discover those organizational factors that help to promote low rates so that other sites can learn how to reduce their rates. Supervisors can take no-show data with them on their supervisory visits to clinics and communicate this information to regional staff so that suitable remedies can be developed. In clinics with high rates, clinic managers may want to follow up the no-show clients that they identify through this tool, either by using clinic outreach workers or by establishing linkages with community-based health promoters.
How to Use This Tool
This step-by-step tool provides a method for identifying a high percentage of no-show clients. Secondly the tool helps in determining the main reasons that cause missed visits at a site or in a program and that could be prevented if organizational changes were made.
The tool is written as if your program uses an appointment system. If it does not, then refer to the variation below.
Variation
If your clinic does not use an appointment system then:
- Define a no-show client in terms of the month of his or her next expected visit. In other words use the month of expected return in the same way you would an appointment date.
Then proceed to questionnaire below.
Sample Survey Questionnaire
- Name
- Age
- Are you currently using a family planning method?
- [If yes] What method are you using today?
- Did you know that you had an appointment to return to the clinic on [insert date]?
- What was the reason that you were supposed to return to the clinic?
- Did you miss the appointment?
- What was the reason that you did not return to the clinic for the appointment?
- Since the appointment, have you stopped using your family planning method? or changed your method?
- If you missed your appointment:
- Did you go to another [name of program] clinic? (Give names of other clinics in the area which are in your program.)
[If no] Did you go to any other clinic?
- Have you been to any of the program clinics since your last appointment [insert date]?
- Have you received any family planning supplies from any other source than the [program] clinics since your last visit to the clinic?
[If yes] Where did you get those supplies?
Developed by:Peter Savosnick in collaboration with Mkomani Clinic Society, Kenya
Used in: Kenya
Language: Available in English
For more information on tracking to identify no-show clients, please refer to The Family Planning Manager, Vol.II, No. 3, "Reducing Discontinuation in Family Planning Programs."
