scholarly journals Comparability of family planning quality of care measurement tools in low-and-middle income country settings: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Elizabeth Hazel ◽  
Diwakar Mohan ◽  
Margaret Gross ◽  
Sushama Kattinakere Sreedhara ◽  
Prakriti Shrestha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Family Planning ◽  
Direct Observation ◽  
Planning Process ◽  
Quality Care ◽  
Middle Income ◽  
Measurement Tools ◽  
Quality Measurements

Abstract Background In low-and-middle income countries (LMICs), accurate measures of the elements of quality care provided by a health worker through family planning services (also known as process quality) are required to ensure family’s contraceptives needs are being met. There are many tools used to assess family planning process quality of care (QoC) but no one standardized method. Those measuring QoC in LMICs should select an appropriate tool based the program context and financial/logistical parameters, but they require data on how well each tool measures routine clinical care. We aim to synthesize the literature on validity/comparability of family planning process QoC measurement tools through a quantitative systematic review with no meta-analysis. Methods We searched six literature databases for studies that compared quality measurements from different tools using quantitative statistics such as sensitivity/specificity, kappa statistic or absolute difference. We extracted the comparative measure along with other relevant study information, organized by quality indicator domain (e.g. counseling and privacy), and then classified the measure by low, medium, and high agreement. Results We screened 8172 articles and identified eight for analysis. Studies comparing quality measurements from simulated clients, direct observation, client exit interview, provider knowledge quizzes, and medical record review were included. These eight studies were heterogenous in their methods and the measurements compared. There was insufficient data to estimate overall summary measures of validity for the tools. Client exit interviews compared to direct observation or simulated client protocols had the most data and they were a poor proxy of the actual quality care received for many measurements. Conclusion To measure QoC consistently and accurately in LMICs, standardized tools and measures are needed along with an established method of combining them for a comprehensive picture of quality care. Data on how different tools proxy quality client care will inform these guidelines. Despite the small number of studies found during the review, we described important differences on how tools measure quality of care.

scholarly journals Private sector delivery of quality care for maternal, newborn and child health in low-income and middle-income countries: a mixed-methods systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e033141
Author(s):  
Samantha R Lattof ◽  
Blerta Maliqi
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Child Health ◽  
Private Sector ◽  
Low Income ◽  
Quality Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Child Health

IntroductionTo accelerate progress to reach the sustainable development goals for ending preventable maternal, newborn and child deaths, it is critical that both the public and private health service delivery systems invest in increasing coverage of interventions to sustainably deliver quality care for mothers, newborns and children at scale. Although various approaches have been successful in high-income countries, little is known about how to effectively engage and sustain private sector involvement in delivering quality care in low-income and middle-income countries. Our systematic review will examine private sector implementation of quality care for maternal, newborn and child health (MNCH) and the impact of this care. This protocol details our intended methodological and analytical approaches, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline for protocols.Methods and analysisFollowing the PRISMA approach, this systematic review will include quantitative, qualitative and mixed-methods studies addressing the provision of quality MNCH care by private sector providers. Eight databases (Cumulative Index to Nursing and Allied Health, EconLit, Excerpta Medica Database, International Bibliography of the Social Sciences, Popline, PubMed, ScienceDirect, Web of Science) and two websites will be searched for relevant studies published between 1 January 1995 and 30 June 2019. For inclusion, studies in low-income and middle-income countries must examine at least one of the following critical outcomes: maternal morbidity or mortality, newborn morbidity or mortality, child morbidity or mortality, quality of care, experience of care and service utilisation. Depending on the data, analyses could include meta-analysis, descriptive quantitative statistics, narrative synthesis and thematic synthesis. Quality will be assessed using tools for qualitative and quantitative studies.Ethics and disseminationFormal ethical approval is not required for this research, as the secondary data are not identifiable. Findings from this review will be used to develop models for effective collaboration of the private and public sectors in implementing quality of care for MNCH. In addition to publishing our findings in a peer-reviewed journal, the findings will be shared through the Quality of Care Network, relevant mailing lists, webinars and social media.PROSPERO registration numberCRD42019143383

scholarly journals Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165627 ◽  
Author(s):  
Gizachew Assefa Tessema ◽  
Judith Streak Gomersall ◽  
Mohammad Afzal Mahmood ◽  
Caroline O. Laurence
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Family Planning ◽  
Family Planning Services

Aged Care Residents’ Perspectives on Quality of Care in Care Homes: A Systematic Review of Qualitative Evidence

2021 ◽  
pp. 016402752198907
Author(s):  
Andrew S. Gilbert ◽  
Stephanie M. Garratt ◽  
Leona Kosowicz ◽  
Joan Ostaszkiewicz ◽  
Briony Dow
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Quality Care ◽  
Care Home ◽  
Aged Care ◽  
Care Homes ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Qualitative Evidence

There is increasing interest in harnessing aged care residents’ perspectives to drive quality improvement in aged care homes. We conducted a systematic review of qualitative evidence including literature examining residents’ descriptions of “quality of care” in aged care homes, using database searches and screening records according to eligibility criteria. Three independent reviewers conducted quality assessment of forty-six eligible articles and performed thematic synthesis of articles’ findings. We distinguish nine key themes describing factors influencing quality care: staffing levels, staff attitude, continuity, routine, environment, decision-making and choice, dignity of risk, activities, and culture and spirituality. While many themes were consistent across studies, residents’ prioritization of them varied. Aged care home residents have differing conceptions of quality care as well as heterogeneous and dynamic needs and preferences. Care providers are best able to facilitate quality care when intentional efforts are made to recognize this and tailor delivery of services the individual residents.

scholarly journals Systematic review of interventions for improving the performance of community health workers in low-income and middle-income countries

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e014216 ◽  
Author(s):  
Madeleine Ballard ◽  
Paul Montgomery
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Community Health ◽  
Performance Improvement ◽  
Community Health Workers ◽  
Health Workers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Biological Outcomes

ObjectiveTo systematically review and critically appraise the evidence for the effects of interventions to improve the performance of community health workers (CHWs) for community-based primary healthcare in low- and middle-income countries.DesignSystematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Methods19 electronic databases were searched with a highly sensitive prespecified strategy and the grey literature examined, completed July 2016. Randomised controlled trials evaluating interventions to improve CHW performance in low- and middle-income countries were included and appraised for risk of bias. Outcomes were biological and behavioural patient outcomes (primary), use of health services, quality of care provided by CHWs and CHW retention (secondary).ResultsTwo reviewers screened 8082 records; 14 evaluations were included. Due to heterogeneity and lack of clear outcome data, no meta-analysis was conducted. Results were presented in a narrative summary. The review found one study showing no effect on the biological outcomes of interest, though these moderate quality data may not be indicative of all biological outcomes. It also found moderate quality evidence of the efficacy of performance improvement interventions for (1) improving behavioural outcomes for patients, (2) improving use of services by increasing the absolute number of patients who access services and, perhaps, better identifying those who would benefit from such services and (3) improving CHW quality of care in terms of upstream measures like completion of prescribed activities and downstream measures like adherence to treatment protocols. Nearly half of studies were compound interventions, making it difficult to isolate the effects of individual performance improvement intervention components, though four specific strategies pertaining to recruitment, supervision, incentivisation and equipment were identified.ConclusionsVariations in recruitment, supervision, incentivisation and equipment may improve CHW performance. Practitioners should, however, assess the relevance and feasibility of these strategies in their health setting prior to implementation. Component selection experiments on a greater range of interventions to improve performance ought to be conducted.

EVALUATION OF AN INTERVENTION TO IMPROVE QUALITY OF CARE IN FAMILY PLANNING PROGRAMME IN THE PHILIPPINES

2011 ◽  
Vol 44 (1) ◽  
pp. 27-41 ◽  
Author(s):  
ANRUDH K. JAIN ◽  
SAUMYA RAMARAO ◽  
JACQUELINE KIM ◽  
MARILOU COSTELLO
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Information Exchange ◽  
Service Providers ◽  
Quality Care ◽  
The Philippines ◽  
Training Intervention ◽  
Control Group ◽  
Contraception Use

SummaryThis paper presents the results of a longitudinal intervention study carried out in the Davao del Norte province of the Philippines. The intervention, tested through a quasi-experimental design, consisted of training of family planning service providers in information exchange and training of their supervisors in facilitative supervision. The training intervention significantly improved providers' knowledge and quality of care received by clients. Moreover, good quality care received by clients at the time of initiating contraception use increased the likelihood of contraceptive continuation and decreased the likelihood of both having an unintended pregnancy and an unwanted birth. However, comparison of women in the experimental group with those in the control group did not show any significant effect of provider-level training intervention on these client-level outcomes. The reasons for this conundrum and the implications for quality of care are discussed.

scholarly journals Experiences of private sector quality care amongst mothers, newborns, and children in low- and middle-income countries: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joe Strong ◽  
Samantha R. Lattof ◽  
Blerta Maliqi ◽  
Nuhu Yaqub
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Private Sector ◽  
Quality Care ◽  
Middle Income ◽  
Private Care ◽  
Middle Income Countries ◽  
Experience Of Care ◽  
Positive Experiences

Abstract Background Experience of care is a pillar of quality care; positive experiences are essential during health care encounters and integral to quality health service delivery. Yet, we lack synthesised knowledge of how private sector delivery of quality care affects experiences of care amongst mothers, newborns, and children. To fill this gap, we conducted a systematic review that examined quantitative, qualitative, and mixed-methods studies on the provision of maternal, newborn, and child health (MNCH) care by private providers in low- and middle-income countries (LMICs). This manuscript focuses on experience of care, including respectful care, and satisfaction with care. Methods Our protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Searches were conducted in eight electronic databases (Cumulative Index to Nursing and Allied Health, EconLit, Excerpta Medica Database, International Bibliography of the Social Sciences, Popline, PubMed, ScienceDirect, and Web of Science) and two websites and supplemented with hand-searches and expert recommendations. For inclusion, studies examining private sector delivery of quality care amongst mothers, newborns, and children in LMICs must have examined maternal, newborn, and/or child morbidity or mortality; quality of care; experience of care; and/or service utilisation. Data were extracted for descriptive statistics and thematic analysis. Results Of the 139 studies included, 45 studies reported data on experience of care. Most studies reporting experience of care were conducted in India, Bangladesh, and Uganda. Experiences of private care amongst mothers, newborns, and children aligned with four components of quality of care: patient-centeredness, timeliness, effectiveness, and equity. Interpersonal relationships with health care workers were essential to experience of care, in particular staff friendliness, positive attitudes, and time spent with health care providers. Experience of care can be a stronger determining factor in MNCH-related decision-making than the quality of services provided. Conclusion Positive experiences of care in private facilities can be linked more broadly to privileges of private care that allow for shorter waiting times and more provider time spent with mothers, newborns, and children. Little is known about experiences of private sector care amongst children. Trial registration This systematic review was registered with the PROSPERO international prospective register of systematic reviews (registration number CRD42019143383).

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