Assessing quality of family planning counseling and its determinants in Kenya: Analysis of health facility exit interviews

Background Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya achieved a modern contraceptive prevalence rate of 60% in 2018, surpassing its 2020 target of 58%. With the high prevalence, focus is geared towards improved quality of family planning services. The objective of this study is to examine the quality of family planning counseling and its associated factors in health facilities in Kenya. Methods We conducted a secondary analysis of the 2019 Kenya Performance Monitoring and Action, client exit data of women who had received family planning services. Quality of counseling was assessed using the Method Information Index Plus. We conducted a multivariable ordinal logistic regression analysis of data from 3,731 women to establish determinants of receiving quality family planning services. Results The Method Information Index Plus score for higher-quality counseling was 56.7%, lower-quality counseling 32.4%, and no counseling 10.9%. Women aged 15–24 years (aOR = 0.69, 95% CI = 0.56–0.86, p = 0.001) had lower odds of receiving better counseling compared to women aged 35 years and above. Those with no education (aOR = 0.52, 95% CI = 0.33–0.82, p = 0.005), primary (aOR = 0.56, 95% CI = 0.44–0.71, p<0.001) and secondary (aOR = 0.79, 95% CI = 0.65–0.98, p = 0.028) were less likely to receive better counseling compared to those with tertiary education. Women who received long acting and reversible contraception methods (aOR = 1.75, 95% CI = 1.42–2.17, p<0.001), and those who were method switchers (aOR = 1.24, 95% CI = 1.03–1.50, p = 0.027), had a higher likelihood of receiving better quality of counseling as compared to those on short-term methods and those who were continuers, respectively. Conclusion The quality of family planning counseling in Kenya is still sub-optimal considering that some women receive no form of counseling at service delivery point. There is need to review the existing FP guidelines and training packages to increase focus on the quality of counseling services offered by health providers. Social accountability strategies that empower women to demand quality services should be included in community-level family planning interventions.

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Quality of Care in Modern Contraceptive Service Delivery in the Public and Private Sector: A Cross Sectional Study in Indonesia

Global Journal of Health Science ◽

10.5539/gjhs.v12n7p102 ◽

2020 ◽

Vol 12 (7) ◽

pp. 102

Author(s):

Ekoriano Mario ◽

Ardiana Irma

Keyword(s):

Quality Of Care ◽

Family Planning ◽

Health Facilities ◽

Modern Contraceptive ◽

Health Providers ◽

Family Planning Services ◽

Public And Private ◽

The Public ◽

Six Elements

The Government of Indonesia has established a set of program interventions to enhance the quality of family planning services. The program gives preferences to the acceptance of family planning services and the readiness of the supply side. This study is intended to better understand the extent to which the public and private sectors deliver quality family planning services in 4 selected provinces within Indonesia. The six elements of quality of care (Bruce, 1990) were utilized as the study framework. The study confirmed that the mean of all six elements of quality of care are significant (alpha =0,05) in two out of the four study sites. From the clients’ point of view, information on contraceptive choices was the most neglected aspect in the public health facilities, while ‘follow up and a continuity mechanism’ was most neglected in the private health facilities. The equity index showed a substantial difference in the overall quality of care between the two types of health facilities (public= 4.53 versus private= 5.34). As far as health providers are concerned, quality of care is still below the optimum standard. Emphasis should be given to formally shape the desired health provider behavior and find a way to create an ‘after-sales-service’ scheme. The concept of quality goals need to be mindful of program maturity across regions. Periodic monitoring and evaluation is required to ensure more client satisfaction which leading to more sustained use of modern contraceptives.

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Quality of Family Planning Counseling in Ethiopia: Trends and determinants of information received by female modern contraceptive users, evidence from national survey data, (2014- 2018)

PLoS ONE ◽

10.1371/journal.pone.0228714 ◽

2020 ◽

Vol 15 (2) ◽

pp. e0228714

Author(s):

Gili Hrusa ◽

Mark Spigt ◽

Tariku Dejene ◽

Solomon Shiferaw

Keyword(s):

Family Planning ◽

Survey Data ◽

National Survey ◽

Modern Contraceptive ◽

Family Planning Counseling

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

Journal of Biosocial Science ◽

10.1017/s0021932006001453 ◽

2006 ◽

Vol 39 (2) ◽

pp. 201-220 ◽

Cited By ~ 10

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.

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

10.21203/rs.3.rs-126972/v1 ◽

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.

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Comparing simulated client experiences with phone survey self-reports for measuring the quality of family planning counseling: The case of depot medroxyprogesterone acetate – subcutaneous (DMPA-SC) in Nigeria

Gates Open Research ◽

10.12688/gatesopenres.12935.1 ◽

2019 ◽

Vol 3 ◽

pp. 1092 ◽

Cited By ~ 1

Author(s):

Nadia Diamond-Smith ◽

Emily Treleaven ◽

Elizabeth Omoluabi ◽

Jenny Liu

Keyword(s):

Mixed Methods ◽

Family Planning ◽

Medroxyprogesterone Acetate ◽

Family Planning Services ◽

Depot Medroxyprogesterone Acetate ◽

Phone Survey ◽

Contraceptive Services ◽

Self Reports ◽

Family Planning Counseling

Background: The quality of family planning services can have important implications for uptake and continued method use. The aim of this analysis is to examine aspects of quality for a new injectable contraceptive method, DMPA-SC (depot medroxyprogesterone acetate – subcutaneous, known as Sayana Press®), service provision and contraceptive services more broadly in Nigeria. Methods: We compared self-reports from follow-up phone surveys with users to simulated client interactions that were designed to measure the same concepts. Through mixed-methods, we sought to more deeply understand the biases associated with different data collection methods that ultimately lead to different conclusions regarding quality of contraceptive services, and to further assess to what extent these methods were suitable for detecting differences in quality across sub-groups using the case of married versus unmarried women. Results: We found that simulated clients reported lower levels of quality across all comparable quality indicators than phone survey respondents attending the same facilities. Both methods were able to detect differential treatment by marital status. Conclusions: A mixed-methods approach can provide differential insights into quality of family planning services, especially when aiming to understand both objective and subjective aspects of quality.

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Do Indian women receive adequate information about contraception?

Journal of Biosocial Science ◽

10.1017/s0021932019000488 ◽

2019 ◽

Vol 52 (3) ◽

pp. 338-352

Author(s):

Md Juel Rana ◽

Anrudh K. Jain

Keyword(s):

Family Planning ◽

Separate Analysis ◽

Background Characteristics ◽

Family Planning Services ◽

Indian Women ◽

Important Indicator ◽

Logistic Regression Models ◽

Information Index ◽

Independent Effects

AbstractThis study analysed the recent changes and patterns of information received about contraceptive methods by contraceptive users in India – an important indicator of quality of care in family planning services. Data were taken from the third and fourth rounds of National Family and Health Surveys (NFHS) conducted in India during 2005–06 and 2015–16. The Method Information Index (MII) was used to capture the information received by respondents on three aspects of contraceptive method use: information about the side-effects of the method, what to do if they experienced any complication from using the method and information received about other methods of contraception. A separate analysis of information received by users about the permanency of sterilization was also carried out. Logistic regression models were applied to assess the independent effects of users’ background characteristics and their states and union territories of residence on method information received by them. The value of the MII nearly doubled from about 16% in 2004–05 to 31% in 2015–16, indicating a marked increase in the information received by contraceptive users in India over the period between 2005–06 and 2015–16. In addition, the percentage of sterilized women who received information about the permanency of the method also increased, from 67% to 80%, over the period. While considerable progress has been made in the last decade, there is still plenty of scope for improvement in the information received by contraceptive users to advance a voluntary approach to family planning.

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Operations Research on the Female Village-Based Family Planning Worker Program of Pakistan

International Quarterly of Community Health Education ◽

10.2190/2duq-lyud-chd0-vrwp ◽

1998 ◽

Vol 18 (3) ◽

pp. 283-305

Author(s):

Louisiana Lush ◽

George P. Cernada ◽

A. K. Ubaidur Rob ◽

Mohammed Shafiq Arif ◽

Minhaj Ul Haque ◽

...

Keyword(s):

Family Planning ◽

Operations Research ◽

Technical Assistance ◽

Field Studies ◽

Family Planning Services ◽

Training And Supervision ◽

The Government ◽

And Training ◽

Broad Program

This article presents the results of a number of operations research studies (OR) of family planning services provided by a new cadre of female village-based family planning workers in Punjab Province, Pakistan. This cadre of workers, recruited nationwide, have been trained to visit women in their villages to provide information and family planning services. The studies were conducted as part of a broad program of technical assistance to the Government of Pakistan. Surveys investigated the quality of their training as well as attitudes among clients to the new program. They found that the program is developing well but there is room for improvement, particularly in counseling and training. Additional field studies are ongoing and recommendations for change have been incorporated in training and supervision. The program is expanding on a national scale.

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