Family Planning
Flipchart
Module 7
Family Planning
Table of Contents:
Lesson 1: Family Planning Introduction and the Exclusive
Breastfeeding Method (LAM)...................................................... 3
Lesson 2: The TwoDay Method .................................................. 7
Lesson 3: CycleBeads ............................................................. 11
Lesson 4: Health Facility Options.............................................. 15
Acknowledgements
The majority of illustrations for LAM, CycleBeads and TwoDay method are from the
Institute for Reproductive Health and Georgetown University. Resources are available
at the following website: http://www.irh.org/ . Additional illustrations come from
Octávio Consalves (Mozambique) and Ir Léonidas Nisabwe (Burundi). Carolyn D.
Wetzel is greatly appreciated for reviewing and editing the materials.
 International HIV/AIDS Alliance. (2002). 100 Ways to Energize Groups: Games
to Use in Workshops, Meetings and the Community. Available at
www.aidsalliance.org.
 Icons for Games and Attendance and Troubleshooting: Röhr-Rouendaal, Petra.
(1997). Where There is No Artist: Development Drawings and How to Use Them.
London, UK:Intermediate Technology Publications.
Suggested Citation: Hanold, Mitzi J. (2011) Family Planning Leader Mother
Flipchart. Washington DC. Food for the Hungry (FH), made possible through support
provided by the Office of Food for Peace, Bureau of Democracy, Conflict, and
Humanitarian Assistances, and the U.S. Agency for International Development under
the terms FFP-A-00-08-00072. The opinions expressed herein are those of the
authors and do not necessarily reflect the view of the U.S. Agency for International
Development.
Lesson 1: Family Planning Introduction and the
Exclusive Breastfeeding Method (LAM)
Materials for Lesson 1:
1. Attendance Registers
1. Game: Rainstorm
2. Attendance and Troubleshooting
3. Story: Too Many Children (Picture 1.1)
Mother B visits a young woman who just delivered her sixth child.
When she arrives the woman is crying. “I am so tired. My body
hurts and I don’t have any strength to care for my children. I
cannot continue to have new babies every year. How can extend
the time before my next pregnancy? The children come too soon!”
4. Ask
? Why is the mother so upset?
? Is it possible to delay new pregnancy? How?
? Are you ready to be pregnant again? If no, what
method are you using to delay new pregnancy?
Let’s compare your thoughts with the messages on the following
pages.
3
Delaying New Pregnancy (Picture 1.2)
5. Show
? What do you see in these pictures?
6. Explain
 Families that delay pregnancy for two years after each birth have
healthy mothers and healthy children.
o Mothers are healthy during and after pregnancy.
o Children grow well and are sick less often than those who
don’t wait.
 Families that do not delay pregnancy suffer from poor health and
sickness.
o Mothers and infants suffer from weak blood.
o Mothers are sick more often during pregnancy.
o Children have less to eat and do not grow well.
 When a woman becomes pregnant too soon, she and her infant
are more likely to die.
o This mother suffered from weak blood in pregnancy.
o She and her infant died during delivery.
? Have you seen mothers suffer because of pregnancies that have
come too soon? Tell me about them.
4
The Exclusive Breastfeeding Method (Picture 1.3)
7. Show
? What do you see in these pictures?
8. Explain
 The Exclusive Breastfeeding method delays new pregnancy for six
months only if the following things are true:
1. The woman’s monthly bleeding has not returned
2. The child is younger than six months
3. The mother never gives water, beer porridge or other foods or
liquids.
4. The mother breastfeeds day and night whenever the child
shows signs of hunger (on the next page).
o Bleeding is a sign that new pregnancy is possible.
o When your baby is six months, new pregnancy is possible.
o If you give other foods and liquids, new pregnancy is
possible.
o These three things must be true if you want to delay new
pregnancy using this method.
?
Are you able to use this method to prevent pregnancy? Why or
why not?
?
What should you do if all of these things are not true?
o Talk with a health worker about other methods to delay new
pregnancy.
5
Practices to Delay New Pregnancy (Picture 1.4)
9. Show
? What do you see in these pictures?
10. Explain
 To delay pregnancy with the Exclusive Breastfeeding method
mothers must breastfeed whenever the child is hungry day and
night.
 Breastfeed even if you or your infant is sick.
o If the mother does not breastfeed when the child shows signs
of hunger, new pregnancy is possible.
o If you stop breastfeeding when you are sick, new pregnancy
is possible.
 While still using the Exclusive Breastfeeding method, choose a new
method so you are ready when this method no longer works.
o Breastfeeding alone is not enough to prevent new pregnancy.
o The four things mentioned above must be true to delay new
pregnancy.
? Do you believe this method works to prevent new pregnancy?
o If these five things are true, 99 out of 100 women using this
method will not become pregnant for six months.
11. Activity: The Four Mothers
14.
Practice
and
Coaching
12. Probe 13. Inform
15. Request 16. Examine
6
Lesson 2: The TwoDay Method
Materials
1. Attendance Registers
2. Two Rocks and a tin or scrap of fabric.
1. Game: Danger Sign Song (Review)
2. Attendance and Troubleshooting
3. Story: Saving My Wife (Picture 2.1)
The men meet together and learn about a new method to delay
pregnancy. The speaker says, “It does not require money or
medicine. However, you must avoid sex or use a condom with your
spouse for two weeks each month.” Some men laugh. Others
shake their heads. One man says, “That is not possible!”
A man stands and says, “Every year my wife has become pregnant
and given birth. My wife is now too weak and sick to care for
herself or our children. To save her life and our family, I am going
to try this new method.”
4. Ask
? How did the men react to this new method? Why?
? Why did the man in the second picture decide to try
the new method?
? Do you think you and your husband (or partner)
could avoid sex or use a condom for 10 to 14 days
each month? Why or why not?
Let’s compare your thoughts with the messages on the following
pages.
7
Understanding Your Monthly Cycle (Picture 2.2)
5. Show
? What do you see in these pictures?
6. Explain
 Each month a woman has some bloody secretions and some nonbloody secretions.
o On this calendar, the woman has four days of bleeding at the
start of the month.
o In the second and third week she has small non-bloody
secretions.
o On the last day of the month her bleeding starts again.
 New pregnancy is possible today if you had non-bloody secretions
today or yesterday.
o If you have sex today, you may become pregnant.
 New pregnancy is not possible today if you had no secretions
today or yesterday.
o If you have sex today, you will not become pregnant.
o The TwoDay method helps women to know on which days
pregnancy is possible.
? Have you noticed these non-bloody secretions before?
? How do your secretions compare to this calendar?
8
Looking for Secretions (Picture 2.3)
7. Show
? What do you see in these pictures?
8. Explain
 Look for secretions when you wipe yourself in the latrine. Look on
your skirt or underclothes.
o Some secretions may be cloudy and sticky.
o Other secretions may be thin and slimy.
 Some women sense (notice) wetness on days with secretions.
o They do not need to look for secretions.
o They can feel wetness during normal activities.
 To prevent new pregnancy, check for secretions twice each day.
Check once in the afternoon and once in the evening.
o Do not look for secretions in the morning.
o Morning secretions may be liquids from sex.
o Secretions may be difficult to notice if you check only once.
? How do you feel about checking for secretions this way?
? Why is it important to check twice each day?
9
Practices to Delay New Pregnancy (Picture 2.4)
9. Show
? What do you see in these pictures?
10. Explain
 New pregnancy is possible if you had secretions today or
yesterday.
o If you had secretions today and yesterday, new pregnancy is
possible.
o If you had secretions yesterday only, new pregnancy is
possible.
o If you have secretions today only, new pregnancy is possible.
 To delay new pregnancy, you and your partner must agree to use
a condom or avoid sex on days when new pregnancy is possible.
o This couple has agreed to delay new pregnancy in this way.
? If a couple wanted to get pregnant, how could they use this
method to become pregnant?
11. Activity: Reminders and Techniques
14.
Practice
and
Coaching
12. Probe 13. Inform
15. Request 16. Examine
10
Lesson 3: CycleBeads
Materials:
1.Attendance Registers
2.CycleBeads for each woman and the CycleBeads pamphlet
1. Game: Hello Hello
2. Attendance and Troubleshooting
3. Story: Finding Secretions is Difficult (Picture 3.1)
Mother B is talking to her neighbor about the TwoDay method. Her
neighbor says, “This method is too hard for me. I can’t tell when I
have secretions and when I don’t.” “There is a necklace which might
help you,” says Mother B. “It is called CycleBeads. You can find
the days when new pregnancy is possible without looking for
secretions."
4. Ask
? Why doesn’t the neighbor like the TwoDay method?
? What have you heard about this necklace?
? What has your experience with the TwoDay method
been in the last two weeks?
Let’s compare your thoughts with the messages on the following
pages.
11
What are CycleBeads? (Picture 3.2)
7. Show
? What do you see in these pictures?
8. Explain
 CycleBeads are another method to identify days when new
pregnancy is possible.
o Each bead represents one day in a month.
o The red bead represents the first day of monthly bleeding.
o The brown beads represent days when pregnancy is not
possible.
o The white beads represent days when pregnancy is possible.
 Move the ring to the red bead on the first day of your monthly
bleeding.
o Begin using CycleBeads on the first day of bleeding.
o If your bleeding has not returned, you cannot use
CycleBeads.
 Each day, move the ring to the next bead in the direction of the
black arrow.
Show
Show
Show
Show
me
me
me
me
the
the
the
the
white beads on your CycleBeads.
brown beads on your CycleBeads.
red bead.
rubber ring.
12
How do you use CycleBeads? (Picture 3.3)
5. Show
? What do you see in these pictures?
6. Explain
 Brown beads represent days when new pregnancy is not possible.
o New pregnancy is not possible if this woman has sex on days
when the ring is on a brown bead.
 White beads represent days when new pregnancy is possible.
o The illustration shows us a woman who is pregnant.
o When the ring is on this bead, the mother may become
pregnant.
 To delay new pregnancy, you and your partner must agree to use
a condom or avoid sex on days when new pregnancy is possible.
o This couple has agreed to delay new pregnancy in this way.
? How many days will you have to avoid sex or use a condom?
o 12 days (count the beads on the necklace)
? What has your experience been so far with avoiding sex and using
condoms? What has helped you to do this?
13
Tracking Your Cycle with CycleBeads (Picture 3.4)
9. Show
? What do you see in these pictures?
10. Explain
 Your bleeding must start between the dark brown bead and the
last brown bead.
o These beads help you to know if CycleBeads will work for
you.
 If your bleeding begins before you reach the dark brown bead,
your bleeding is too early.
o You cannot use CycleBeads to prevent new pregnancy.
 If your bleeding does not start the day after you reach the last
brown bead, your bleeding is too late.
o You cannot use CycleBeads to prevent new pregnancy.
 If you are not able to use CycleBeads talk with a health worker
about other methods to delay new pregnancy.
? Which women cannot use CycleBeads?
11. Activity: The Four Women
14.
Practice
and
Coaching
12. Probe 13. Inform
15. Request 16. Examine
14
Lesson 4: Health Facility Options
Materials
1. Attendance Registers
2. Research the cost of each procedure at the health facility
1. Game: The Germ Song (Review)
2. Attendance and Troubleshooting
3. Story: I Want to Be Sure (Picture 2.1)
The man with six children comes to Mother B’s husband. “We have
been using CycleBeads, but we have trouble avoiding sex on days
when pregnancy is possible. I want to be sure that she doesn’t get
pregnant for at least two more years.” Mother B’s husband says,
“If you are willing to spend money, there are more options at the
health facility. Those options do not require avoiding sex on days
when pregnancy is possible.”
4. Ask
? Why did the man come to Mother B’s husband?
? What options are available at the health facility?
? Have you ever used a family planning method
from the health facility? Tell us about it.
Let’s compare your thoughts with the messages on the following
pages.
15
Pills and Injections (Picture 4.2)
9. Show
? What do you see in these pictures?
10. Explain
 Special pills can be taken each day to prevent new pregnancy.
o Microgyno30 is the name of one type of pill.
o Take one pill each day.
o When you skip a day or miss a pill, new pregnancy is
possible.
o To delay new pregnancy, use one package of pills each
month.
 A special injection prevents pregnancy for two months (8 weeks).
o This injection is called Noristerat or NET-EN.
o For two months, new pregnancy is not possible.
o To delay new pregnancy, return every 8 weeks for a new
injection.
? Would you be willing to try these methods to prevent new
pregnancy? Why or why not?
16
IUD and Implants (Picture 4.3)
9. Show
? What do you see in these pictures?
10. Explain
 Small tubes inserted under the skin prevent new pregnancy for five
years.
o The name of these tubes is Norplant.
o When the tubes are removed, new pregnancy is possible.
o To delay new pregnancy, return every five years for a new
implant.
 This small device is put deep inside the body to prevent pregnancy
for five to ten years.
o The IUD can be removed by a health worker to allow new
pregnancy at any time.
o The IUD must be removed or replaced every five years.
? Would you be willing to try one of these procedures to prevent new
pregnancy? Why or why not?
17
Spermicides and Counseling (Picture 4.4)
9. Show
? What do you see in these pictures?
10. Explain
 Spermicides are inserted just before sex to prevent new
pregnancy.
o Spermicides may be tablets, creams or foam.
o Place the tablet deep into the vagina.
o Insert tablet before each act of sex.
 Meet with a health worker to discuss the different options.
o The health worker can give advice and answer questions.
o If you are unhappy with one method, try another one.
 Ask the health worker about the danger signs of each method.
o These methods may cause headaches, nausea, and changes
in monthly bleeding.
 Return to the health center if you don’t feel well.
? Do these methods prevent STIs or HIV?
o Condoms prevent STIs and HIV transmission. Spermicides
provide some protection from STIs. They are more effective
when used with a condom.
11. Activity: Comparing Options
14.
Practice
and
Coaching
12. Probe
13. Inform
15. Request
16. Examine
18
19