Implementation Of Balanced Counseling Strategy In Postpartum Family Planning Decision-Making: A Scoping Review

Abstract

Background: Postpartum family planning (PPFP) is a critical intervention for improving maternal and infant health and preventing unintended pregnancies. The quality of counseling plays a key role in supporting informed and sustainable contraceptive decision-making. The Balanced Counseling Strategy (BCS) is a patient-centered counseling approach designed to assist clients in making informed choices aligned with their needs and preferences. Objectives: This study aims to map the scientific evidence on the implementation of the Balanced Counseling Strategy (BCS) in postpartum family planning decision-making.

Method: This study employed a scoping review design based on the Arksey and O’Malley framework, further refined by the Joanna Briggs Institute (JBI) guidelines. Literature searches were conducted in PubMed, ScienceDirect, Wiley Online Library, and Google Scholar for articles published between 2020 and 2025. A total of 19 articles met the inclusion criteria and were analyzed using thematic synthesis.

Result: The findings identified seven main themes, including the effectiveness of BCS in improving knowledge, attitudes, and contraceptive decision-making, increased uptake of long-term contraceptive methods, the importance of patient-centered counseling, healthcare provider capacity, and the influence of sociocultural and health system factors. Several studies reported statistically significant improvements in contraceptive decision-making outcomes following BCS implementation.  Conclusion: The Balanced Counseling Strategy is an effective and relevant approach for supporting postpartum family planning decision-making. Its success is influenced by healthcare provider capacity, sociocultural context, and health system support. Strengthening provider training, addressing workload challenges, and integrating BCS into routine maternal health services are essential to optimize its implementation.

Conclusion: The Balanced Counseling Strategy is an effective and relevant approach for supporting postpartum family planning decision-making. Its success is influenced by healthcare provider capacity, sociocultural context, and health system support. Strengthening provider training, addressing workload challenges, and integrating BCS into routine maternal health services are essential to optimize its implementation.