The quality of care in family planning services: an assessment of family welfare centres in Gujranwala, Pakistan

Abstract

# Background To assess the quality of provision, the present study assessed ten core needs of clients attending family planning services including information, access, choice, safety, privacy, confidentiality, dignity, comfort and continuity of care as well as the opinion of clients on the service provision. # Methods In this study 11 Family Welfare Centres (FWCs) were selected proportionally from total 51 FWCs and this study was carried out in the Gujranwala district of Punjab, Pakistan. A sample of size of 600 married women, aged 15-45 years was selected with at least one surviving child and these women were using any contraceptive method. Quantitative analysis was performed to identify links between needs and quality of care. # Results Significant weaknesses in addressing the needs of clients were identified. 55.8% of clients were not informed how to use different contraceptive methods while 62.5%, due to low economic status, could not afford to choose any but the cheapest methods so were unable to access the full range and potentially more appropriate methods for them. 63.5% were not given the method of their own choice and 63% were not counselled about the management of side-effects. 51% said they were counselled in the presence of other clients and 59% were not informed about follow-up visits. Overall 51.2% of respondents rated quality of care poor in terms of their satisfaction. # Conclusions Any family planning program should focus on the needs of clients not numbers seen to achieve their targets. More attention should be given to filling the gaps in needs of clients with a better provision of information and choice as well as continuity of care.