Abstract
AbstractBackground: Private for-profit health institutions are expanding, and making considerablecontributions to improve health care for significant number of population. Their crucial share inreproductive health (RH) services in this area is growing rapidly. Assessing the quality of servicebeing provided by the private sector particularly in the area of RH provision has paramountimportance.Objective: To assess the quality of RH services at private for-profit health institutions in AddisAbaba and to provide programmatic recommendations.Methods: A descriptive cross-sectional study was conducted to assess the quality of service using astructured questionnaire through client exit interview, service provider interview, observation ofclient-provider interaction, provider’s technical competence and using a checklist for inventory ofequipment and supplies of health institutions. The study was conducted from April to December2006.Result: Ten private for profit health institutions were included in this study. A total of 411clients who came to receive RH services including family planning (FP), antenatal care(ANC),delivery services, postnatal care(PNC), post abortion care(PAC) and sexually transmittedinfection (STI) management were studied. Among others fourty six service providers wereinterviewed and 76 observations of client-provider interactions were made. Overall 91.2% exitinterview respondents reported satisfaction with services they received. In multivariate analysis,satisfaction of clients was lower for those women who reported waiting for a long time withoutgetting the service (OR=0.07, 95% CI: 0.03, 0.16), those who were not treated politely(OR=0.04, 95% CI: 0.01, 0.11), those who did not get satisfactory response for their questions(OR=0.02, 95% CI: 0.01, 0.08),and those with short consultation time (OR=0.13, CI: 0.05,0.31). All of the study institutions had basic equipment and supplies for the services. Majority ofthe providers received basic training in RH services. Inadequate supervision, less use of IECmaterials, and missed opportunity for VCT services was identified as a problem.Conclusion: Improving the use of IEC materials, refresher training and supportive supervisionfor the service providers by responsible authorities are recommended. It is suggested that creating amechanism to reduce long waiting time can improve client satisfaction.Keywords: Private for profit health sector, quality reproductive health services, Supportive supervision1Ethiopian Society of Obstetricians and Gynecologists, 2Department of Community Health, Addis Ababa University
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