Family Planning Care Services Research Articles

Healthcare providers’ perspectives on use of the national guideline for family planning services in Amhara Region, Ethiopia: a qualitative study

ObjectiveTo explore healthcare providers’ views on barriers to and facilitators of use of the national family planning (FP) guideline for FP services in Amhara Region, Ethiopia.DesignQualitative study.SettingNine health facilities including...

Client and facility level determinants of quality of care in family planning services in Ethiopia: Multilevel modelling.

IntroductionOver the last two decades, while contraceptive use has improved in Ethiopia, the contraceptive prevalence rate remains low. In addition to socio-demographic and cultural factors, the quality of care in Family Planning (FP) services is an important determining factor of FP utilization. However, little research exists on the determinants of quality of care in FP services in Ethiopia. This study aims to identify the client and facility level determinants of quality of care in FP services in Ethiopia.MethodsThis study was based on the first Ethiopian Services Provision Assessment Plus (ESPA+) survey conducted in 2014. A total of 1247 clients nested in 374 health facilities were included in the analysis. Multilevel mixed-effects logistic regression modelling was conducted. The outcome variable, client satisfaction, was created using polychoric principal component analysis using eleven facets that reflect client satisfaction.ResultsThe results showed that both client-level and facility-level factors were associated with quality of care in FP services in Ethiopia. At the client-level; provision of information on potential side effects of contraceptive method (AOR = 5.22, 95% CI: 2.13–12.80), and number of history and physical assessments (AOR = 1.19, 95% CI: 1.03–1.34) were positively associated with client satisfaction, whereas waiting times of 30 minutes to two hours (AOR = 0.11, 95% CI: 0.03–0.33) was negatively associated with client satisfaction. At the facility-level; urban location (AOR = 4.61, 95% CI: 1.04–20.58), and availability of FP guidelines/protocols for providers (AOR = 4.90, 95% CI: 1.19–20.19) had positive significant effect on client satisfaction.ConclusionQuality improvement programs in FP services in Ethiopia should focus on shortening waiting times and provision of information about the potential side effects of contraceptive methods. It is also important to improve health providers’ skills in thorough client history taking and physical assessment. Further distribution and implementation of best practice guidelines for providers working in the FP services must be a priority.

Quality of care in family planning services in Senegal and their outcomes

BackgroundHigh quality of care in family planning (FP) services has been found to be associated with increased and continued use of contraceptive methods. The interpersonal skills and technical competence of the provider is one of the main components of quality of care. To study the process component of quality of care, the distribution of the FP counseling topics was examined by client, provider and facility characteristics. To assess the outcomes of quality of care, client satisfaction and their knowledge of their method’s protection from STIs were used. This study examined the factors associated with these outcomes with a focus on provider counseling and training.MethodsData from the 2012–2013 Senegal Service Provision Assessment survey was used for the analysis. The survey included a representative sample of the health facilities in Senegal and collects data by observing the clients’ FP visits and conducting exit interviews. The main outcomes of interest were provider’s counseling in FP, client’s satisfaction with FP services and client’s knowledge of their method’s protection from STIs. Several covariates were used in the analysis which represent client, provider and facility characteristics.ResultsThe level of counseling was inadequate-- very low proportions of providers that performed different types of counseling. Counseling was more likely to be provided to new than returning clients. Approximately 84% of the clients were very satisfied with services but only 58% had correct knowledge of their method’s protection from STIs. Clients were significantly less likely to be very satisfied when their providers counseled on side effects and when to return, and counseling provided on method’s protection from STIs did not significantly improve knowledge in this area. Clients seen by a provider with FP training had almost twice the odds of having correct knowledge about their method’s protection from STIs compared with clients seen by a provider with no recent training.ConclusionsThe percentage of providers offering FP counseling to their clients was relatively low and was ineffective on the client-focused outcomes. Interventions may be required for more effective counseling methods that are client-centered as well as providing more FP training to providers.

Assessment of Client Satisfaction on Family Planning Services Utilization in Wonji Hospital, Ethiopia, 2016

Background: Patients have the right to expect quality of care. Providing quality of care in family planning services is an important task for care providers so as to increase services utilization and coverage. Research of Hospital based patient satisfaction on family planning service utilization is rare in some regions of Ethiopia. Both availability and quality of family planning services are believed to have contributed to increase contraceptive use and declining fertility rates in developing countries. Objective: The objective of this study is to assess the client satisfaction on family Planning services utilization provided in wonji hospital, Oromia state, Ethiopia, 2016. Methodology: A cross-sectional study design will be used during the study period from September 1-October 30, 2016. All women of reproductive age group (15-49) who visit wonji hospital family planning unit with all service providers. During the study period were source populations. All family planning users and service providers who were available during the study period were taken as sample. The sampling technique employed is systematic sampling method. Data were collected by face to face interview and observation during the procedure done by using English version semi-structured questionnaire. The quality of data collection process will be monitored by giving clear instructions to the data collectors. The results of the study are summarized using tables and graphs. Result: A total of hundred female contraceptive users and five service providers included in this study. Thirty eight percent are illiterate, 83% were married, 49% are 21-30 years old and 66% are residence in town. The dominant numbers of the clients know family planning method. Injection 59 (59%) and oral contraceptive pills 22 (22%) are the most frequently used. About 45 (45%) of the client was got both information and service together. Among interviewed client 56 (56%) % of the clients have >30 min waiting time to get the service. Most of the client 59 (59%) didn’t get information on long term family planning. Almost 56 (55%) of client were not satisfied for family planning service given. For clients’ satisfaction waiting time, insufficient information with the service and not informing on long term family planning, marital status and education were found important factors. Conclusion: Client satisfaction on utilization of family planning service is low in Wonji hospital. Clients are informed well on short term contraceptives method than on long term. Method choices are generally limited to hormonal methods, injectable and oral contraceptive pill being dominant methods. Waiting time, insufficient information with the service and not informing on long term family planning, marital status and education are important factors affecting client satisfaction on family planning utilization. The health professionals have to improve client satisfaction on utilization of family planning services.