Philippines and Senegal: Services improve quality of care but fail to increase FP continuation

2002 ◽  
Author(s):  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Reproductive Health ◽  
Service Delivery ◽  
The Philippines ◽  
Supportive Supervision ◽  
Improve Quality ◽  
Population Council ◽  
The Impact

In 1999, Frontiers in Reproductive Health collaborated on studies on the impact of interventions to improve quality of care in the Philippines and Senegal. The two interventions were part of a multicountry Population Council study (also undertaken in Pakistan and Zambia) to test whether improving quality affects women’s contraceptive continuation. The Philippines study focused on training in family planning (FP), supportive supervision, and refresher courses to improve client-provider interaction. The Senegal study compared the impact of improved quality of care at five newly established “reference centers” with five clinics that served as controls. Data were gathered through analyses of quality of care at all 10 sites in 1997, when the reference centers had begun implementation, and in 1998, 16 months later. As detailed in this brief, the introduction of client-centered service delivery with a focus on the client-provider interaction resulted in better quality of care at sites in the Philippines and Senegal. However, improving quality of care alone was not found to be sufficient to significantly increase the length of time women continued to use contraception.

scholarly journals Physician beliefs about the impact of meaningful use of the EHR

2014 ◽  
Vol 05 (03) ◽  
pp. 789-801 ◽  
Author(s):  
D.Y. Ting ◽  
M. Healey ◽  
S.R. Lipsitz ◽  
A.S. Karson ◽  
J. S. Einbinder ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Primary Care Physicians ◽  
Meaningful Use ◽  
The United States ◽  
Improve Quality ◽  
Cross Sectional ◽  
Incentive Program ◽  
Physician Beliefs ◽  
The Impact

SummaryBackground: As adoption and use of electronic health records (EHRs) grows in the United States, there is a growing need in the field of applied clinical informatics to evaluate physician perceptions and beliefs about the impact of EHRs. The meaningful use of EHR incentive program provides a suitable context to examine physician beliefs about the impact of EHRs.Objective: Contribute to the sparse literature on physician beliefs about the impact of EHRs in areas such as quality of care, effectiveness of care, and delivery of care.Methods: A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who were preparing to qualify for the meaningful use of EHR incentive program.Results: Of the 1,797 physicians at both AMCs who were preparing to qualify for the incentive program, 967 completed the survey for an overall response rate of 54%. Only 23% and 27% of physicians agreed or strongly agreed that meaningful use of the EHR will help them improve the care they personally deliver and improve quality of care respectively. Physician specialty was significantly associated with beliefs; e.g., 35% of primary care physicians agreed or strongly agreed that meaningful use will improve quality of care compared to 26% of medical specialists and 21% of surgical specialists (p=0.009). Satisfaction with outpatient EHR was also significantly related to all belief items.Conclusions: Only about a quarter of physicians in our study responded positively that meaningful use of the EHR will improve quality of care and the care they personally provide. These findings are similar to and extend findings from qualitative studies about negative perceptions that physicians hold about the impact of EHRs. Factors outside of the regulatory context, such as physician beliefs, need to be considered in the implementation of the meaningful use of the EHR incentive program.Citation: Emani S, Ting DY, Healey M, Lipsitz SR, Karson AS, Einbinder JS, Leinen L, Suric V, Bates DW. Physician beliefs about the impact of meaningful use of the EHR: A cross-sectional study. Appl Clin Inf 2014; 5: 789–801http://dx.doi.org/10.4338/ACI-2014-05-RA-0050

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 Using COPE to improve quality of care: The experience of the Family Planning Association of Kenya

1998 ◽  
Author(s):  
Janet Bradley ◽  
Judith Bruce ◽  
Soledad Diaz ◽  
Carlos Huezo ◽  
Kalimi Mworia
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Improve Quality ◽  
The Family

scholarly journals Person-centred Quality, Provider Involvement and Family Planning Continuation in India

2020 ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Beth Phillips ◽  
Patience Afulani ◽  
Aradhana Srivast ◽  
Ginger Golub ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Quality Measures ◽  
Power Dynamics ◽  
Care Experience ◽  
Person Centered Care ◽  
Centered Care ◽  
And Gender ◽  
The Impact

Abstract Background: Quality of care of family planning provision has many dimensions, and measuring and understanding these different components is challenging. Furthermore, understanding which components are most important for women’s experiences and method continuation is essential for improving the quality of care provision. Methods: We use longitudinal data from India to explore the impact of different measures of quality (provider preference, provider involvement, and a newly developed scale of person-centered care experiences) on method continuation. We also look at associations between the quality measures and discuss why different measures may be more salient in different contexts. Results: We find that a woman’s person-centered care experience is not associated with continuation in India. Providers having a strong preference is associated with continuation. Conclusions: Certain measures of person-centered quality appear to impact family planning continuation, but the validated person-centered care measure is not. Socio-cultural factors such as power dynamics and gender norms likely impact expectations, and need to be considered in interpreting and choosing quality measures.

scholarly journals The Anorexia Nervosa Care Pathway: Closing the Treatment Gap to Improve Care for Patients Admitted to Medical Hospitals

2021 ◽  
Author(s):  
Kathryn Allen ◽  
Kate O Brien ◽  
Marese O'Reilly ◽  
Deirbhile Henderson ◽  
Siobhan Machale ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Quality Of Care ◽  
Care Pathway ◽  
High Rate ◽  
Medical Complications ◽  
Hospital Inpatient ◽  
Improve Quality ◽  
Medical Monitoring ◽  
The Impact

Introduction: Medical complications of malnutrition and refeeding account for approximately half of deaths in anorexia nervosa (AN). The AN Care Pathway (ANCP) was introduced at our institution in 2016 to improve quality of care of patients admitted for medical observation and management. We report results from our review of medical complications and report the impact and adoption of the ANCP. Methods: The ANCP was developed in response to a need to improve quality of medical monitoring of patients with severe AN using Squire Guidelines and the Plan-Do-Study-Act cycle. All patients admitted to a medical hospital with AN between 2010-2020 were included after hospital inpatient enquiry and medical records were reviewed. Descriptive statistics were calculated using Stata (Statcorp). Results: Fifty-one patients (63 admissions) were included. Median BMI was 13.8 kg/m2 (11.9-22.5). After ANCP implementation in 2016, compliance with recommended daily ECG, thiamine and blood tests improved from 30% (n=8/27) to 86% (n=21/36). We report a high rate of medical complications of severe AN including anaemia (n=24, 47%), neutropoenia (n=18, 35%), abnormal liver bloods (n=15, 29%) and half developed refeeding syndrome. One-third patients had cardiovascular compromise including reduced cardiac contractility (n=13, 25%), pericardial effusion (n=7, 14%) and one death. Low BMI was associated with cardiovascular complications (mean BMI 13.5 kg/m2 vs 15.5 kg/m2, p=0.01) and neutropoenia (mean BMI 13.4 kg/m2 vs 15.4 kg/m2, p=0.02). Conclusion: Introduction of the ANCP improved quality of care during medical stabilisation. We report a high rate of medical complications of severe AN in patients admitted to a medical hospital. Use of multidisciplinary care protocols may contribute to quality improvement and improved consistency of care for this vulnerable population.

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.

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