scholarly journals Assessment of segmentation and targeted counseling on family planning quality of care and client satisfaction: a facility-based survey of clients in Niger

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ilene S. Speizer ◽  
Hachimou Amani ◽  
Jennifer Winston ◽  
Souleymane Amadou Garba ◽  
Amelia Maytan-Joneydi ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Client Satisfaction ◽  
Contraceptive Use ◽  
Scale Up ◽  
Quality Of Services ◽  
High Fertility ◽  
Modern Contraceptive ◽  
The Government

Abstract Background Niger demonstrates high fertility and low contraceptive use that are typical in much of the West and Central African region. The government of Niger has committed to increasing modern contraceptive use as part of its health strategy. Designing and testing strategies to improve quality of care and satisfaction of family planning clients is important for addressing low contraceptive use in contexts like Niger. Methods This study uses recently collected client exit interview data from 2720 clients surveyed in the Dosso region of Niger to examine whether implementation of segmentation-based counseling leads to improved quality of services and client satisfaction. We compare three scenarios: a) facilities where segmentation counseling was implemented since 2017; b) facilities where segmentation counseling began in late 2019; and c) facilities without segmentation counseling. Bivariate and multivariate analyses are undertaken to determine if there are differences in quality of services and client satisfaction between the facility groups and between clients that were segmented and those who were not segmented in the first two scenarios. Results Results demonstrate that clients in facilities with segmentation generally received better quality services than clients in facilities without segmentation. Clients in facilities implementing segmentation longer reported higher quality services than the recent segmentation facilities. Clients who were segmented compared to those who were not segmented also reported better quality services. New clients reported higher quality services than returning clients and among new clients, those who were segmented also reported higher quality services. No differences were found in client satisfaction between facility scenarios or between segmented and non-segmented clients. Conclusions These findings demonstrate that segmentation or another targeted counseling strategy could be useful to the government of Niger to improve the quality of services offered. As part of the scale up process, the government needs to consider strategies that ensure that all new clients are segmented and design an approach that is sustainable and does not risk failing should there be stock-out of segmentation sheets or loss of counseling cards. This type of targeted counseling could improve the quality of services offered and ideally lead to increased contraceptive use in Niger.

EFFECT OF FAMILY PLANNING SERVICES ON MODERN CONTRACEPTIVE METHOD CONTINUATION IN VIETNAM

2006 ◽  
Vol 39 (2) ◽  
pp. 201-220 ◽  
Author(s):  
MAI P. DO ◽  
MICHAEL A. KOENIG
Keyword(s):  
Family Planning ◽  
Contraceptive Method ◽  
Contraceptive Use ◽  
Quality Of Services ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Modern Contraceptive Method ◽  
Health Centres ◽  
Outreach Programme

Summary.Access to and quality of services have increasingly been the focus of family planning programme managers, implementers and researchers in the developing world. In Vietnam, a country characterized by recent significant achievements in family planning, not much is known about the linkages between service accessibility and quality and contraceptive behaviour. Data for this study come from the Vietnam 1997 Demographic and Health Survey, with individual contraceptive use information recorded in the calendar section. Measures of access to and quality of services come from the Community/Health Facility Questionnaire, with key informant interviews and facility visits. The study focuses on the effects of the outreach programme and commune health centres on contraceptive method discontinuation for three modern, temporary methods: the IUD, oral pills and condoms. Longer travel time to commune health centres is found to be associated with significantly increased risks of first- and all-method discontinuation for any reason, while residence in communities with higher quality health centres is associated with significantly lower risks of method discontinuation. Access to and quality of the outreach programme are, in contrast, not significant determinants of method discontinuation for any reason. Similar results are found for first- and all-method discontinuation for service-related reasons. The effects of programmatic factors are more pronounced among older women and during the first three months of method use. This study provides evidence for the importance of family planning services for contraceptive method continuation in Vietnam. The results also highlight the need for a thorough evaluation of the family planning outreach programme in terms of its facilitation of women’s continued use of contraception.

scholarly journals Family planning counseling and its associations with modern contraceptive use, initiation, and continuation in rural Uttar Pradesh, India

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Nabamallika Dehingia ◽  
Anvita Dixit ◽  
Sarah Averbach ◽  
Vikas Choudhry ◽  
Arnab Dey ◽  
...  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Uttar Pradesh ◽  
Married Women ◽  
Modern Contraceptive ◽  
Advantages And Disadvantages ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
Continued Use

Abstract Background We examine the association between the quality of family planning (FP) counseling received in past 24 months, and current modern contraceptive use, initiation, and continuation, among a sample of women in rural Uttar Pradesh, India. Methods This study included data from a longitudinal study with two rounds of representative household survey (2014 and 2016), with currently married women of age 15–49 years; the analysis excluded women who were already using a permanent method of contraceptive during the first round of survey and who reported discontinuation because they wanted to be pregnant (N = 1398). We measured quality of FP counseling using four items on whether women were informed of advantages and disadvantages of different methods, were told of method(s) that are appropriate for them, whether their questions were answered, and whether they perceived the counseling to be helpful. Positive responses to every item was categorized as higher quality counseling, vs lower quality counseling for positive response to less than four items. Outcome variables included modern contraceptive use during the second round of survey, and a variable categorizing women based on their contraceptive use behavior during the two rounds: continued-users, new-users, discontinued-users, and non-users. Results Around 22% had received any FP counseling; only 4% received higher-quality counseling. Those who received lower-quality FP counseling had 2.42x the odds of reporting current use of any modern contraceptive method (95% CI: 1.56–3.76), and those who received higher quality FP counseling at 4.14x the odds of reporting modern contraceptive use (95% CI: 1.72–9.99), as compared to women reporting no FP counseling. Women receiving higher-quality counseling also had higher likelihood of continued use (ARRR 5.93; 95% CI: 1.97–17.83), as well as new use or initiation (ARRR: 4.2; 95% CI: 1.44–12.35) of modern contraceptives. Receipt of lower-quality counseling also showed statistically significant associations with continued and new use of modern contraceptives, but the effect sizes were smaller than those for higher-quality counseling. Conclusions Findings suggest the value of FP counseling. With a patient-centered approach to counseling, continued use of modern contraceptives can be supported among married women of reproductive age. Unfortunately, FP counseling, particularly higher-quality FP counseling remains rare.

THE IMPACT OF DEMAND FACTORS, QUALITY OF CARE AND ACCESS TO FACILITIES ON CONTRACEPTIVE USE IN TANZANIA

2005 ◽  
Vol 39 (1) ◽  
pp. 1-26 ◽  
Author(s):  
MARY ARENDS-KUENNING ◽  
FLORA L. KESSY
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Cultural Values ◽  
Contraceptive Use ◽  
Data Sets ◽  
Demand Side ◽  
Family Planning Services ◽  
Unmet Demand ◽  
The Impact

The low contraceptive prevalence rate and the existence of unmet demand for family planning services present a challenge for parties involved in family planning research in Tanzania. The observed situation has been explained by the demand-side variables such as socioeconomic characteristics and cultural values that maintain the demand for large families. A small, but growing body of research is examining the effect of supply-side factors such as quality of care of family planning services on the demand for contraceptives. This paper analyses the demand and supply factors determining contraceptive use in Tanzania using the Tanzania Service Availability Survey (1996) and the Tanzania Demographic and Health Survey (1996) data sets. The results show that access to family planning services and quality of care of services are important determinants of contraceptive use in Tanzania even after controlling for demand-side factors.

scholarly journals Metrics for monitoring and improving quality of care in family planning

2020 ◽  
Author(s):  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Contraceptive Use ◽  
Evidence Based ◽  
Training Materials ◽  
Routine Monitoring ◽  
And Training

Despite the widely agreed importance of measuring quality of care (QoC), client perspectives are often missing from routine monitoring and studies. The Evidence Project has developed a package of validated, evidence-based tools and training materials to support governments and implementing partners in measuring and monitoring QoC. Measuring QoC from the clients’ perspective will help programs celebrate successes, target areas for improvement, and ultimately improve uptake and continuation of voluntary contraceptive use. This brief gives a brief overview of those findings.

scholarly journals Examining and strengthening the role of patent and proprietary medicine vendors in the provision of injectable contraception in Nigeria

2018 ◽  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Scale Up ◽  
Health Sector ◽  
Modern Contraceptive ◽  
Public And Private ◽  
Care Experience ◽  
Contraceptive Services ◽  
Injectable Contraceptives

Results from an implementation research study in Nigeria found that with training, Patent and Proprietary Medicine Vendors (PPMVs), regardless of their previous health care experience, could competently administer injectable contraceptives and that clients reported receiving quality services from trained PPMVs. From 2015 to 2018, the Evidence Project conducted a study to better understand the role of PPMVs in offering voluntary injectable services (e.g., selling, counseling, referring to health centers, and administering). The study was conducted in response to Nigeria's family planning context and the role of PPMVs in the informal health sector. | In Nigeria, the bulk of contraceptive services are provided by private sources, including hospitals, clinics, pharmacies, and PPMVs. Of the contraceptives used, injectable contraception is the most popular, accounting for approximately 40 percent of modern contraceptive use in the country. Among both public and private sources for family planning, PPMVs are the most popular for voluntary contraceptive services. According to Nigeria's 2013 National Demographic Health Survey, 38 percent of all contraceptive users and 13 percent of injectable users received their method from a PPMV. | The knowledge generated from this study helps inform the potential scale-up of PPMV delivery of voluntary injectable contraceptive services. The evidence provides insights on how to support and mentor PPMVs to provide quality FP counseling and provision of injectable contraceptives.

scholarly journals The role of structural and process quality of family planning Care in Modern Contraceptive use in Indonesia: a multilevel analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nurjaeni Nurjaeni ◽  
Yothin Sawangdee ◽  
Umaporn Pattaravanich ◽  
Charamporn Holumyong ◽  
Aphichat Chamratrithirong
Keyword(s):  
Family Planning ◽  
Multilevel Analysis ◽  
Contraceptive Use ◽  
Process Quality ◽  
Structural Quality ◽  
Modern Contraceptive ◽  
Contraceptive Usage ◽  
Modern Contraceptive Use

Abstract Introduction Despite contraceptive behaviors are influenced by multiple and multilevel variables, studies on modern contraceptive use in Indonesia has concentrated on single-level and mostly individual and household variables, and less interest has been devoted to multilevel analysis that accounts for community and SDP characteristics that may affect woman’s decision to use modern FP method. This study aimed to assess the role of structural and process quality of family planning care in modern contraceptive use among women in reproductive ages in Indonesia. Methods This study analyzed data from the 2016 PMA2020 survey of 10,210 women in 372 enumeration areas in Indonesia. The data were analyzed using categorical principal component analysis and multilevel mixed-effects logistic regression. Results The key variables for structural quality were number of contraceptive provided, SDP supports CHWs, available water and electricity, and skilled FP personnel, while the main factors for process quality were privacy of clients and provision of post-abortion service. There were significant differences across communities in how study variables associated with modern FP adoption. The finding shows the evidence of significant roles of structural and process quality FP care in modern contraceptive use. Moreover, women with high autonomy in FP decision, those who had free national/district health insurance, and those living in a community with higher proportion of women visited by CHW, had higher odds of modern contraceptive usage. Yet, women who live in a community with higher mean ideal number of children or greater proportion of women citing personal/husband/religion opposition to FP, had lower odds of modern contraceptive use than their counterparts. Conclusion Study findings suggest improvement in structural and process quality of FP care will yield substantial growths in modern contraceptive use. Moreover, FP workers should also address adverse cultural/traditional customs in community and should target communities where the demand for modern FP was degraded by opposing social beliefs and norms. There was significant variation across communities in how individual, household, community, and SDP factors affect modern FP practice, hence, context should be taken into consideration in the development of FP intervention and promotion programs.

scholarly journals IntegratE Project results: Family planning knowledge and quality of care received from community pharmacists and patent and proprietary medicine vendors

2021 ◽  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Service Providers ◽  
Point Of Care ◽  
Regulatory System ◽  
Community Pharmacists ◽  
Modern Contraceptive ◽  
Accreditation System ◽  
Widespread Availability

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As the Federal Ministry of Health explores expanding its task sharing policy to include CPs and PPMVs, evidence is needed on an effective regulatory system to support CPs and PPMVs in providing high-quality FP services. The IntegratE Project (2017-21) seeks to increase access to contraceptive methods by involving the private sector in FP service delivery in Lagos and Kaduna states. The Project seeks to establish a regulatory system with the Pharmacists Council of Nigeria to ensure that CPs and PPMVs provide quality FP services and comply with regulations. To achieve this, the Project is implementing a pilot accreditation system for PPMVs. CPs function outside the pilot accreditation system but would receive the same training. This brief compares knowledge of FP and quality of care received among PPMVs and CPs as reported by FP clients served.

scholarly journals Quality of Family Planning Care as Enabling Factor for Modern Contraceptive Use in Indonesia: Evidence from PMA2020 Survey

2021 ◽  
Author(s):  
Nurjaeni Nurjaeni ◽  
Yothin Sawangdee ◽  
Umaporn Pattaravanich ◽  
Charamporn Holumyong ◽  
Aphichat Chamratrithirong
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Number Of Children ◽  
Modern Family ◽  
Modern Contraceptive Use ◽  
Ideal Number ◽  
Modern Family Planning

Abstract BackgroundThe utilization of modern family planning methods is a key pointer that mirrors universal access to reproductive health cares. Fulfilling unmet needs for modern contraceptives may decrease the level of maternal mortality by almost a third. This research employed the 2016 PMA2020 survey to assess multilevel variables related to modern family planning method use among women of reproductive age in Indonesia. MethodData from interviews of female and Service Delivery Point (SDP) of the 2016 Performance Monitoring and Accountability 2020 (PMA2020) survey were linked to generate a merged dataset comprising women’s individual, cluster and SDP factors (N=10,210). Multilevel analysis was done to assess the influence of contextual factors including a summary index of SDP quality FP care on woman’s modern family planning practice. Adjusted odds ratios and 95% CIs were analysed and interpreted.ResultsModern contraceptive prevalence among women of childbearing age was 42.3% in 2016. There was a considerable variation in the likelihood of modern method use across the 372 clusters/EAs. Age, education, marital status, parity, residency, region, woman’s FP decision autonomy, cluster’s average ideal number of children, percentage of females dissatisfied with FP, and percent of females visited by CHVs were significant factors for modern FP use after adjusting for multilevel characteristics. Quality of FP care was revealed to be a significant enabling factor for modern contraceptive use in Indonesia. ConclusionsModern contraceptive prevalence among females aged 15-49 years was relatively low in 2016. The findings indicate that an advancement in modern method use can be gained by improving quality of family planning care. Likewise, an enhancement in women’s FP decision autonomy and their level of education, decline in women’s ideal number of children and diminution of the dissatisfaction with family planning are all major concerns to be addressed. Family planning policies must tackle adverse cultural norms and inequities in quality of family planning care and women’s education that would produce welfares to women, children, and communities.

scholarly journals Do provider behaviors influence client satisfaction of family planning services in Togo? Evidence from a cross-sectional facility survey

2020 ◽  
Author(s):  
Leanne Dougherty ◽  
Kathryn Spielman ◽  
Martha Silva
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Client Satisfaction ◽  
Secondary Analysis ◽  
Reproductive Age ◽  
Visual Aids ◽  
Family Planning Services ◽  
Cross Sectional ◽  
Process Factors

Abstract BackgroundStrengthening quality of family planning care is a key objective in Togo to improve maternal and reproductive health. Structural attributes or inputs to care, and process attributes or content of care, including providers’ interaction with clients, are key factors determining quality of care. Client satisfaction with family planning services is linked to contraceptive uptake and continuation, yet the relationship between quality of care elements and client satisfaction of family planning services has not been assessed in Togo, particularly process factors related to client-provider interactions. MethodsWe conduct a secondary analysis using data from a facility-based survey. The survey was conducted in August 2016 in six health districts of Lomé Togo, including a facility audit (N=16), client observations (N=1096) and client exit interviews with women of reproductive age (N=1089). We used multi-variable logistic regression to assess the association between factors related with service structure and process, including provider-client interaction and client perception of provider treatment as a proxy for client satisfaction.ResultsWe did not find a relationship between structural attributes of quality and client perception of provider treatment. Among process attributes, we found that several behaviors related to interpersonal skills, including encouraging clients to ask questions and asking clients to describe any concerns they have with their method, and providers use of visual aids were significantly associated with client perception of provider treatment. ConclusionThe quality of care a woman receives when seeking to adopt or continue family planning methods is essential to improving use of family planning service. Family planning programs must address provider related behaviors that may inhibit the uptake and continuation of contraceptive use, and strengthen inter-personal skills, which may improve client perception of provider treatment with services and facilitate their continued use.

scholarly journals Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yolandie Kriel ◽  
Cecilia Milford ◽  
Joanna Paula Cordero ◽  
Fatima Suleman ◽  
Petrus S. Steyn ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Quality Of Care ◽  
Family Planning ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Care Providers ◽  
Contraceptive Methods ◽  
Integration Of Services

Abstract Background Quality of care is a multidimensional concept that forms an integral part of the uptake and use of modern contraceptive methods. Satisfaction with services is a significant factor in the continued use of services. While much is known about quality of care in the general public health care service, little is known about family planning specific quality of care in South Africa. This paper aims to fill the gap in the research by using the Bruce-Jain family planning quality of care framework. Methods This formative qualitative study was conducted in South Africa, Zambia, and Kenya to explore the uptake of family planning and contraception. The results presented in this paper are from the South African data. Fourteen focus group discussions, twelve with community members and two with health care providers, were conducted along with eight in-depth interviews with key informants. Thematic content analysis using the Bruce-Jain Quality of Care framework was conducted to analyse this data using NVIVO 10. Results Family planning quality of care was defined by participants as the quality of contraceptive methods, attitudes of health care providers, and outcomes of contraceptive use. The data showed that women have limited autonomy in their choice to either use contraception or the method that they might prefer. Important elements that relate to quality of care were identified and described by participants and grouped according to the structural or process components of the framework. Structure-related sub-themes identified included the lack of technically trained providers; integration of services that contributed to long waiting times and mixing of a variety of clients; and poor infrastructure. Sub-themes raised under the process category included poor interpersonal relations; lack of counselling/information exchange, fear; and time constraints. Neither providers nor users discussed follow up mechanisms which is a key aspect to ensure continuity of contraceptive use. Conclusion Using a qualitative methodology and applying the Bruce-Jain Quality of Care framework provided key insights into perceptions and challenges about family planning quality of care. Identifying which components are specific to family planning is important for improving contraceptive outcomes. In particular, autonomy in user choice of contraceptive method, integration of services, and the acceptability of overall family planning care was raised as areas of concern.

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