Client-Centeredness of Family Planning Services in a Resource Limited Setting.

Abstract

Clients' needs and their satisfaction are priority issues in studying quality in reproductive health services. However, only 24-37% of Ethiopian women were informed about the available family planning methods and their utilization. High national total fertility rate (4.8) and low contraceptive prevalence rate (29%) might be attributed to these and other reasons. This study assessed the level of client-centeredness of family planning services and their determinants in public health facilities of Bahir Dar Town, Northwest Ethiopia. Exit interviews of 326 consecutively enrolled clients were conducted using structured questionnaire. Thirty consultation sessions were observed using a checklist to record client-provider interaction. The outcome variable was client centeredness as measured by perceived informed choice with perceived client-provider interaction as the intermediate variable. The average levels of perceived informed choice and client provider interaction were 70.0% and 67.6%, respectively. Perceived clinical competence of providers, perceived integration and coordination of care, perceived accessibility of services, perceived participation of families and friends in care delivery, perceived physical comfort of the facilities and type of the health facility were the independent predictors of perceived client provider interaction. Perceived degree of client provider interaction, perceived clinical competence of providers, type of health facility and perceived accessibility of services were independent predictors of perceived informed choice (p≤0.01). Client-centeredness of family planning services, as measured by clien-provider interaction and informed choice was not sufficiently assured in the study facilities.