Measuring Family Planning Service Quality through Client Satisfaction Exit Interviews

Abstract

A model client exit interview developed by the International Planned Parenthood Federation Western Hemisphere Region was used to measure levels of client dissatisfaction with various components of quality. During 1993-96 89 surveys of more than 15000 clients were conducted in eight Latin American and Caribbean countries. The areas of quality that most often received more than 5% negative response from clients (termed negative response cases) were waiting time (mentioned in 70% of surveys) with a mean dissatisfaction level of 20%) ease of reaching the clinic (in 54% with an average dissatisfaction level of 12%) and price of services (47% and 10% respectively). Using the survey results participating family planning associations made changes to improve quality in these areas ranging from improving appointment systems to relocating to implementing sliding fee scales. Results from 16 subsequent follow-up surveys showed a decline in each country in the number of negative response cases as well as in the mean level of dissatisfaction. For example in Brazil the mean number of negative response cases per survey declined from 2.7 to 2.2 and the mean level of dissatisfaction among them fell from 19% to 11%. Well-known problems of measuring client satisfaction may be addressed by focusing on a low threshold of dissatisfaction as a way to uncover shortcomings in service quality. Although declines in dissatisfaction cannot be attributed entirely to the changes made as a result of the use of the questionnaires client surveys can provide a quick and inexpensive way of determining areas of service where quality could be improved. These kinds of improvements will be necessary if service providers hope to become more sustainable and if they are to help clients meet their reproductive health needs. (authors)