Patient-centered infertility questionnaire for female clients (PCIQ-F): part I: questionnaire development

Background Patient-centered care is an essential component of health care quality. To achieve patient-centered care, health care authorities should have a clear definition and an applicable tool to measure the extent of its application. The real concept of patient centeredness should be developed by the patients themselves. We aimed to demonstrate a way to develop a draft Arabic patient-centered infertility care (PCIC) questionnaire for females clients following practical steps that address women with infertility. Methods An iterative process of questionnaire development was undertaken by combining two approaches: the steps proposed by Robert F. DeVellis for scale development and the recommended practices for questionnaire development and testing in the European statistical system. We attempted to develop the draft questionnaire that involved conceptualization and operationalization, generation of an item pool, development of the questionnaire format, review of the initial item pool by experts, and consideration of validation items for inclusion. Results We generated an item pool from in-depth interviews with 14 women who sought infertility care within 6 months before the interview time. We then added more items from a literature review. The item pool contained 123 items distributed through 10 domains. Ten women with infertility were included for face validation. Then, experts with backgrounds in Obstetrics and Gynecology, Family Medicine, and Public Health reviewed the item pool using content validation (n = 10 professors and/or specialists). The item pool was finally reduced to 57 items. We developed the draft Arabic patient-centered infertility care questionnaire for female clients (PCIQ-F) with three sections, including 66 items: background variables, PCIC experience variables, and a general question about the quality of infertility care in the health facility. The draft questionnaire was further reviewed and edited last by experts in preparation for part 2, which will test the questionnaire and prepare the final version. Conclusion The PCIQ-F questionnaire development is a multi-step iterative process started and ended by the target users as experts. Experts’ participation in infertility care and in questionnaire format development had a great impact on questionnaire development and conflict resolution. We recommend this transparent and replicable approach for new instrument developers; it is likely to generate a questionnaire that is valid and acceptable to target users. The draft PCIQ-F questionnaire is ready for testing of its psychometric properties before the final version to measure the PCIC level in health facilities.

Application of Muslim Family Law as a Form of Customary Law in Accra, Ghana

This article examines the central role of the malam (Islamic scholar) in the application of Muslim family law in a legal plural tradition in Accra, Ghana. It demonstrates that the role of the malam as a legal actor is one which is not self-ascribed, yet his deployment of such role is significant in how we understand the interaction of various bodies of laws and their hierarchies. The article shows that women form the majority of the litigants who seek to improve their wellbeing by appealing to Islamic legal norms through the malamai. It argues that, through the judicial practices of the malamai of the two dominant Islamic groups, the Tijāniyya and the Salafiyya, the manner in which the malam himself deploys his legal role reveals how his position is relevant for his predominantly female clients. In the end, this article contributes to how we understand the practice of legal pluralism through the application of Muslim family law as a form of customary law.

Female Clients Satisfaction towards Primary and Secondary Eye Health Facilities and Cost of Eye Care in Nepal

Introduction: In Nepal, females suffer from disproportionately higher burden of blindness and vision impairment with low access to eye care. The available knowledge is inadequate to address the issues related to gender and generate information to reduce the gender disparity. The aim of this study was to determine female clients’ satisfaction with services at eye facilities in Nepal and to estimate the cost of cataract surgery. Materials and methods: Exit interviews were conducted in 2018 with 308 female clients from eight facilities in five districts. Face to face interviews were conducted using a pretested semi-structured questionnaire adopted from the midterm review of Vision 2020. Results: The mean age of participants was 54±17 years. Ninety seven percent (97%) of the participants reported that they received service as per their expectation and were satisfied with the service of the facilities. Major factors for satisfaction were: thorough eye examination (54%), behavior of health staff (40%), and cleanliness of health facility (39%). Another eighty percent (80%) of the participants mentioned that they would recommend or return to the same facility. Fifteen percent of the participants perceived that they faced problems at the eye facility because of their gender. Around three quarters (73%) paid health expenses from their pocket. Most (83%) of the participants rated user fees as either reasonable or inexpensive. Conclusion: The majority of participants reported receiving service as expected and willingness to return to the same eye health facility for future consultation. However, most participants had to pay the health care expenses out-of-pocket.

Introduction: Special section ‘female clients of commercial sex’

In this introduction to the special section ‘female clients of commercial sex’, we start by an overview of the early interest in research on male clients of commercial sex and the tendency to criminalize and pathologize them. Then, we will question and discuss the lack of interest and the difficulties of researching women clients. Subsequently, we will look at the literature investigating women paying for sex to better understand and situate the research included in this section. After that, we will examine the contributions of the articles included in this special section and finish by reflecting on the meaning of this issue for future research on sex work.

MALE AND FEMALE CLIENTS OF MEN PROVIDING SEXUAL SERVICES: RESEARCH REPORT

The aim of the research was to gain knowledge of who the people using sexual services are, why they do it and what their relationship with men offering paid sex looked like. Results show that the people who used sexual services were both men and women of different ages and with different professional status. The main reasons for using paid sex services were: unsatisfactory sexual contact,; a sense of loneliness and being neglected by the life partner, partner’s infertility, heartbreak or betrayal of a partner, problems with finding the right partner, unusual sexual preferences, change of gender and treatment of sex-meetings as a form of entertainment.

The Effect of Women's Financial Self-Efficacy on Financial Product Ownership

The government is intensively implementing formal and informal education to improve individual financial literacy. This study aims to examine the effect of women's financial self-efficacy on financial product ownership, controlling for contributing to financial literacy, financial risk preferences, and demographic factors. The sample consists of 253 female respondents who live in Surabaya and already have financial products. The data are collected using questionnaires and processed using binary logistic regression. The results show that women's financial self-efficacy significantly affects the choice of financial products in the form of investment, credit cards, and other loans. However, it does not significantly affect the choice of financial products in the form of savings, mortgages, health insurance, and life insurance. This study is expected to provide benefits in developing learning methods to appropriately improve women's financial literacy according to the available financial product choices. Besides, this study is also expected to provide advice to female clients to diversify their investment product portfolios according to their personalities to achieve their financial goals.

Performance monitoring and accountability: The Agile Project’s protocol, record and experience

The Performance Monitoring and Accountability 2020 (PMA2020) project implemented a multi-country sub-project called PMA Agile, a system of continuous data collection for a probability sample of urban public and private health facilities and their clients that began November 2017 and concluded December 2019. The objective was to monitor the supply, quality and consumption of family planning services. In total, across 14 urban settings, nearly 2300 health facilities were surveyed three to six times in two years and a total sample of 48,610 female and male clients of childbearing age were interviewed in Burkina Faso, Democratic Republic of Congo, India, Kenya, Niger and Nigeria. Consenting female clients with access to a cellphone were re-interviewed by telephone after four months; two rounds of the client exit, and follow-up interviews were conducted in nearly all settings. This paper reports on the PMA Agile data system protocols, coverage and early experiences. An online dashboard is publicly accessible, analyses of measured trends are underway, and the data are publicly available.