Quality Of Family Planning Services Research Articles

PR Media Relations Strategy In Improving The Quality Of Family Planning (Kb) Services In Ntt Province Population And National Family Planning Agency (Bkkbn)

The purpose of this study was to determine the Media Relations Public Relations Strategy of the National Population and Family Planning Board (BKKBN) of the NTT Province in Improving the Quality of Family Planning (KB) Services. The method used in this research is a type of qualitative research. It discusses in depth to better understand phenomena such as opinions, desires, feelings, and behavior of media relations regarding the strategies and media relations activities carried out by BKKBN. The scope of the research is in the Public Relations Section of the Office of the National Population and Family Planning Agency (BKKBN) of the Province of NTT which provides services to the community. Data collection techniques used in this study were interviews, observation and documentary studies. While the data analysis technique used is data analysis using descriptive qualitative analysis techniques. The results of the research conducted were the quality of service through the media relations strategy in the Public Relations of the BKKBN in the Province of NTT above. It can be concluded that the services through the strategy of media relations in the Public Relations of the BKKBN in the Province of NTT have gone well because: a) there is timeliness in providing information; b) provide information or news to the mass media in dealing with problems or issues that arise in society and the willingness to help customers and provide services quickly; c) generate trust and confidence, which is the ability of Public Relations in creating a sense of public trust in the NTT BKKBN including communication, credibility, security, competence and courtesy; d) provide information through the media or publications and conduct events for the community related to knowledge, specific community needs; and e) displaying physical facilities, equipment or technology and the appearance of employees at the NTT Coordinating and Family Planning Agency (BKKBN) Office

Community perspectives on family planning service quality among users and non-users: a qualitative study from two cities in Burkina Faso

BackgroundMost studies that focus on quality of family planning (FP) services collect data from facilities. These studies miss the perspectives of quality from women who do not visit a facility and for whom perceived quality may be a barrier to service utilization.MethodsThis qualitative study from two cities in Burkina Faso examines perceived quality of FP services from women who were recruited at the community level to avoid potential biases based on recruiting women at facilities. Twenty focus group discussions were undertaken with varying groups of women of different ages (15–19; 20–24; 25+), marital statuses (unmarried; married), and current modern contraceptive use experiences (current non-users; current users). All focus group discussions were undertaken in the local language and transcribed and translated into French for coding and analysis.ResultsWomen discuss FP service quality in a variety of locations, depending on their age group. Perspectives on service quality for younger women are often informed by others’ experiences whereas for the older women, they are formed by their own and others’ experiences. Two important aspects of service delivery emerge from the discussions including interactions with providers and selected system-level aspects of service provision. Important components of provider interactions relate to (a) the initial reception from the provider, (b) the quality of counseling received, (c) stigma and bias from providers, and d) privacy and confidentiality. At the health system level, discussions revolved around (a) wait time; (b) stockouts of methods; (c) costs of services/methods; (d) the expectation for tests as part of service provision; and (e) difficulties with method removal.ConclusionsTo increase contraceptive use among women, it is crucial to address the components of service quality they identify as related to higher quality services. This means supporting providers to offer services in a more friendly and respectful manner. In addition, it is important to ensure that full information is provided to clients on what to expect during a visit to avoid false expectations that lead to poor perceived quality. These types of client-focused activities can improve perceptions of service quality and ideally support use of FP to meet women’s needs.

Informed choice and its associated factors among women received immediate postpartum long-acting reversible contraceptives at public hospitals in Sidama Regional State, Ethiopia, 2022

IntroductionIt is crucial to ensure the quality of family planning (FP) services through women's informed choice during the provision of long-acting reversible contraceptives. In Ethiopia, previous studies have focused on the quality of family planning services. However, much emphasis was not given to the informed choice of immediate postpartum long-acting reversible contraceptives (LARCs), particularly in the study area. This study determines the mangnitude of informed choice and associated factors among immediate postpartum women who received long-acting reversible contraceptives.MethodAn institution-based cross-sectional study was conducted from July 1 – August 31, 2022, among 373 immediate postpartum women who received long-acting reversible contraceptives at public hospitals in the Sidama regional state, Ethiopia. Women were selected and interviewed using a systematic random sampling technique and via a structured interviewer-administered questionnaire respectively. Data was collected using Kobo Toolbox software and then exported to the Statistical Package for Social science (SPSS) version 25 for analysis. A logistic regression model was used to identify the predictor variables.ResultsThe magnitude of informed choice of long-acting reversible contraceptives was 23.5% (95% CI (19.6%–27.7%)). The messages through posters about long-acting reversible contraceptives at the facility (AOR 3.6, 95% CI (1.92–6.79), postpartum family planning counseling during antenatal care (AOR 2.8, 95% CI (1.2–6.4), previous contraceptive use (AOR 3.23, 95% CI (1.12–9.33), and being secondary and higher educated (AOR 2.92, 95%CI (1.27–6.73) and (AOR 5.7, 95% CI (2.267–14.669) respectively were factors significantly associated with informed choice during immediate postpartum family planning service.Conclusion and recommendationIn the current study, nearly one-fourth of women were informed about LARCs. Socio-demographic factors, prior use of contraception, exposure to posters that have messages about long-acting reversible contraceptives, and postpartum family planning counselling during antenatal care are factors that affect the woman's ability to make an informed choice. There should be immediate PPFP counselling that focuses on a full range of contraceptive method choices to facilitate postpartum women's ability to make informed choices.

"You could find a good or a bad provider, I would say you just have to go and see": A qualitative study of the influence of perceptions of service quality on family planning service use in Burkina Faso.

This qualitative study from Burkina Faso explores community-level perceptions of family planning (FP) service quality among FP users and non-users. It examines how perspectives on service quality may influence women's motivation to seek modern methods from health facilities. For this study, twenty focus group discussions were undertaken with non-users and current users of modern FP including unmarried, sexually active women ages 15-19 and 20-24 and ever married women ages 15-24 and 25+ in Bobo Dioulasso and Banfora, Burkina Faso. The findings demonstrate that respondents prioritized a welcoming environment, positive provider-client exchanges, the full provision of information (especially about side-effects), a pain-free experience, a short waiting time, and privacy and confidentiality. Poor service quality did not, in general, reduce women's demand or need to use a FP method. Some women who were reluctant to use formal health services used a non-facility-based method (calendar method, withdrawal, condoms or abstinence). Importantly, many unmarried, younger women and adolescents, who were more likely to be stigmatized by providers, exhibited agency by proactively seeking a method despite the potential for a negative experience. They prioritized their health and wellbeing over and above any interpersonal barriers they were likely to encounter. Incorporating strategies to improve the quality of FP services based on locally defined elements of quality should be a specific programmatic goal. These strategies can be identified through quality assessments employing a woman-centered lens. Women who visit facilities can be encouraged to share their positive experiences with their networks to improve community-level perspectives of facility quality. Improving service quality can attract new users, especially adolescents, and retain those who have already adopted a FP method. Through these multi-pronged actions, women's (and community) expectations and experience of quality can improve. This, in turn, may lead to greater client satisfaction and associated higher FP prevalence.

Building trust through quality of service mediated with satisfaction to acceptors of family planning in the province of South Kalimantan

This study aims to analyze the effect of service quality on the satisfaction of Long-Term Contraception Method family planning acceptors, analyze the effect of family planning service quality on the trust of Long-Term Contraception Method family planning acceptors, analyzing the effect of acceptor satisfaction on trust, and analyzing the effect of service quality on trust which is mediated by the satisfaction of couples of Long-Term Contraception Method acceptors. So that it can be a reference in making future family planning programs so that it is right on target and can control the rate of population growth. This study uses a quantitative approach, namely research that emphasizes analysis of numerical data obtained by statistical methods to test hypotheses so that the significance of the relationship between the variables studied is obtained. The number of samples in this study was 120 respondents in data collection using multistage sampling and simple random sampling techniques, data analysis techniques using path analysis using the SEM-PLS program. The results showed that the variable quality of family planning officers had a positive and significant effect on the satisfaction of family planning acceptors, the variable of service quality of family planning officers had a positive and significant effect on the trust of family planning acceptors, the variable of satisfaction with family planning acceptors had a positive and significant effect on the trust of family planning acceptors, and the variable of service quality of family planning officers. positive and significant effect on the trust of family planning acceptors mediated by the satisfaction of family planning acceptors using Long-Term Contraception Method.

Sistem Informasi Pengelolaan Obat Dan Alat Kontrasepsi Berbasis Web Pada Dinas Pengendalian Penduduk Dan Keluarga Berencana Kota Jambi

Family planning services are one of the basic health services, so the Ministry of Health has established family planning as one of the mandatory health programs that must be supported. One of the supporting factors for improving the quality of family planning and reproductive health services is the availability of drugs and contraceptives in the family planning warehouse. For this reason, optimal management of drugs and contraceptives is required. The management system for drugs and contraceptives at the Jambi City Population Control and Family Planning Service is still done manually and using Microsoft Office Excel so that the management and reporting of drugs is still not optimal. This research produces a prototype that can be implemented further so as to produce a web-based drug and contraceptive management information system at the Jambi City Population Control and Family Planning Office.

The Quality of Family Planning (FP) Program through Family Information System in Banda Aceh City

This study aims to analyze the service quality of the Family Planning (FP) program through the family information system (SIGA) in Banda Aceh City. The problem in this study is how the quality of FP program services is implemented through a family information system and how the strategy is to improve family planning services in the Banda Aceh city government. The approach used in this research is qualitative. The data collection technique was carried out through interviews using interview guides as instruments. The informants were 20 people, determined by purposive sampling technique, consisting of officers providing contraceptive service data, leaders of health facilities (Public Health Center, Public Health Center Help, and private clinics), contraceptive users who received services at these health facilities, and local government civil servants working for the FP program. The analysis was carried out by categorizing words and classifying answers from interviews. Transcripts and voice recordings are sorted by source and interview date. This study found that there were 7 (seven) themes in the quality of FP services in Banda Aceh City, namely: 1) Easy access to health facilities: 2) Some small obstacles in the field; 3) The use of procedures in family planning services, especially contraceptive services: 4) The selection of contraceptives by the acceptors and the use of the ABPK flipchart in FP counseling have a good effect on the acceptors' decisions in choosing contraceptives: 5) The recording and reporting of contraceptive services is very adequate: 6) Good attitude of health facilities staff in providing FP

How well are Indonesia's urban poor being provided access to quality reproductive health services?

Accommodating the needs of Indonesia’s rapidly growing urban population is essential to reaching national reproductive health goals and international commitments. As in other rapidly urbanizing low- and middle-income countries, satisfying the needs of Indonesia’s urban poor is both a high priority and a significant challenge. In this study, we assessed both how being from urban poor or near-poor households affects the quantity and quality of family planning and maternal health services received and the extent to which differentials had narrowed during the 2012–2017 period. This time interval is significant due to the introduction of a national social health insurance scheme in 2014, establishing the foundation for universal health care in the country. Data from the 2012 and 2017 Indonesian Demographic and Health Surveys were analyzed using logistic and multinomial logit regression. Poverty status was measured in terms of urban household wealth quintiles. For family planning, although urban poor and near-poor women made different method choices than non-poor women, no substantial 2017 differences in contraceptive prevalence, unmet need for family planning or informed choice were observed. However, urban poor women and to a lesser extent near-poor women systematically lagged non-poor urban women in both the quantity and quality of maternal health services received in connection with recent pregnancies. Significant maternal health service gains were observed for all urban women during the study reference period, with gains for poor and near poor urban women exceeding those for non-poor on several indicators. While the deployment of pro-poor interventions such as the national social health insurance scheme is likely to have contributed to these results, evidence suggesting that the scheme may not be influencing consumer health-seeking behaviors as had been anticipated along with continued limitations in public health sector supply-side readiness resulting in service quality issues suggest that more will have to be done.

Survival time to Implanon discontinuation and its predictors among a cohort of Implanon users who enrolled in public hospitals of southern Ethiopia, 2021: a retrospective cohort study

BackgroundPieces of evidence strongly indicate that providing high-quality family planning services is accompanied by an increase in contraceptive uptake and a decrease in contraception discontinuation. Contraceptive, especially Implanon discontinuation is a global issue that could be linked to a summary outcome indicator of poor family planning service quality. Although Implanon is becoming more popular among Ethiopian contraceptive users, little is known regarding the survival and predictors of discontinuation. The study aimed at exploring the survival and predictors of Implanon discontinuation among women enrolled in family planning units of Public hospitals in southern Ethiopia, 2021.MethodsA hospital-based retrospective cohort study was conducted among Implanon users who enrolled in family planning units of Public Hospitals. Five years of medical records, from January 1, 2016, to December 30, 2020, were reviewed. A total of 502 women were selected by using a random sampling technique. A standardized abstraction tool was used to collect data from medical records and registration books. The data were entered into Epidata Version 3.1 and then exported to STATA 14 for analysis. The median was calculated in the case of survival time. Across covariates, the Kaplan Meier survival curve was used to estimate time to Implanon discontinuation. To identify statistically significant predictors of Implanon discontinuation, a multivariable Cox proportional hazard model was fitted.ResultsThe incidence rate of Implanon discontinuation was 1.87(95% CI = 1.63, 2.15) per 100 person-months of observation. The overall estimated survival probability at the end of 24 and 36 months was 67.4% (95%CI, 62.5, 71.8) and 25.9% (95%CI, 18.4, 34.1) months respectively. Residence [AHR = 1.50; 95%CI: 1.09, 2.08], parity [AHR = 2.02; 95%CI: 1.65, 3.67], pre-insertion counselling [AHR = 2.41; 95%CI: 1.72, 3.70], experiencing heavy vaginal bleeding [AHR = 3.91; 95%CI: 2.67, 5.32], post-insertion follow up [AHR = 3.15; 95%CI:2.11, 4.75] were identified as a significant predictors of Implanon discontinuation.ConclusionThe risk Implanon of discontinuation was high, especially at 24 and 36 months. In family planning service delivery points, health care providers should pay special attention to clients who live in rural areas and do not have children. In addition, health care providers should provide pre-insertion counseling and post-insertion follow-up that focus on potential side effects. Finally, family planning units need to engage in early side effect management and reassurance to mitigate discontinuation.

Role of financial incentives in family planning services in India: a qualitative study

BackgroundIn an effort to encourage Family Planning (FP) adoption, since 1952, the Government of India has been implementing various centrally sponsored schemes that offer financial incentives (FIs) to acceptors as well as service providers, for services related to certain FP methods. However, understanding of the role of FIs on uptake of FP services, and the quality of FP services provided, is limited and mixed.MethodsA qualitative descriptive study was conducted in Chatra and Palamu districts of Jharkhand state. A total of 64 interviews involving multiple stakeholders were conducted. The stakeholders included recent FP acceptors or clients, FP service providers of public health facilities including Accredited Social Healthcare Activists (ASHAs), government health officials managing FP programs at the district and state level, and members of development partners supporting FP programs in Jharkhand. Data analysis included both inductive and deductive strategies. It was done using the software Atlas ti version 8.ResultsIt has emerged that there is a strong felt need for FP among majority of the clients, and FIs may be a motivator for uptake of FP methods only among those belonging to the lower socio economic strata. For ASHAs, FI is the primary motivator for providing FP related services. There may be a tendency among them and the nurses to promote methods which have more financial incentives linked with them. There are mixed opinions on discontinuing FIs for clients or replacing them with non-financial incentives. Delays in payment of FIs to both clients and the ASHAs is a common issue and adversely effects the program.ConclusionFIs for clients have limited influence on their decision to take up a FP method while different amounts of FIs for ASHAs and nurses, linked with different FP methods, may be influencing their service provision. More research is needed to determine the effect of discontinuing FI for FP services.

Quality of Care in Family Planning Services: Differences Between Formal and Informal Settlements of Kira Municipality, Uganda.

Background: Quality of care (QoC) of family planning (FP) affects contraceptive use, and it varies across types of urban settlement. This study assesses the difference in service delivery point (SDP) structural and process factors between formal and informal urban settlements, and the opinion of the client on the QoC in informal settlements. This is useful in creating an evidence base to advocate for better quality services for the most vulnerable in society.Methods: This was a cross-sectional survey that included SDPs of Kira municipality in Wakiso district, Uganda. Data were collected from all the service points in Kira municipality with the caretakers consented. In addition, using multi-stage sampling, 626 women of reproductive age (15–49 years) who lived in the informal settlements of Kira municipality were interviewed. Data were collected using structured questionnaires, descriptive analysis was carried out in Stata version 14.0, and Chi-square and t-tests were used to compare the informal with the formal settlements.Results: Formal settlements generally had more higher-level SDPs compared to informal settlements (value of p < 0.001). SDPs in the formal settlements provided more FP methods and had more community health workers (CHW) to support their work. Also, SDPs in the formal settlements were more likely to have long-term FP methods available and more likely to have trained personnel to insert and remove implants and IUDs compared to those in informal settlements. Additionally, more SDPs in the formal settlements provided counseling for permanent, long-term, and short-term FP methods. Of the 626 interviewed women, most of the women (68.6%) reported that they would not return to the previous FP provider or refer a friend to the same provider (72.7%).Conclusions: There is a lower quality FP services in the informal settlements with a commensurable effect on the client satisfaction with the services. Therefore, improving the quality of FP services in informal settlements should be a top priority. Improved quality of services could act as a motivation to increase the uptake of modern contraceptives in such settings.

Perceptions Toward the Use of Digital Technology for Enhancing Family Planning Services: Focus Group Discussion With Beneficiaries and Key Informative Interview With Midwives

BackgroundModern family planning (FP) methods allow married couples to discuss and determine the number of children and years of spacing between them. Despite many significant improvements in FP services in Jordan, there are still many issues related to the uptake of FP services for both host communities and Syrian refugees, due to limitations in the health care system based on public health facilities. Digital technologies can provide opportunities to address the challenges faced in the health system, thus offering the potential to improve both coverage and quality of FP services and practices.ObjectiveThe aim of this study was to explore the perceptions of Jordanian women, Syrian refugees, and midwives in Jordan toward the use of digital health technology to support and enhance access to FP services.MethodsWe employed a qualitative study based on semistructured, face-to face key informative interviews with 17 midwives (providers) and focus group discussions with 32 married women of reproductive age (clients). Both midwives and clients were recruited from 9 health centers in 2 major governorates in Jordan (Irbid and Mafraq), where 17 in-depth interviews were conducted with midwives and 4 focus groups were conducted with the women. Each focus group included 4 Syrian refugees and 4 Jordanian women. The transcribed narratives were analyzed using inductive thematic analysis.ResultsThree major themes were derived from the narratives analysis, which covered the pros of using digital technology, concerns about digital technology use, and the ideal app or website characteristics. Ten subthemes emerged from these 3 main themes. Overall, midwives and women (Syrian refugees and host communities) agreed that digital technology can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman’s awareness and knowledge regarding the FP methods and their side effect. Furthermore, digital technology can assist in enabling women’s empowerment, which will allow them to make better decisions regarding FP use. No harmful risks or consequences were perceived to be associated with using digital technology. However, several concerns regarding digital technology use were related to eHealth literacy and the accuracy of the information provided. Midwives were mainly concerned about the patients who would rely mostly on the technology and choose to avoid consulting a health care professional.ConclusionsAs perceived by midwives and women, incorporating digital technology in FP services can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman’s awareness regarding the FP methods and their side effect. It may also empower the women to play an active role in the shared (with their husband and family) decision-making process. Therefore, digital technologies are recommended to address the challenges faced in health system and to improve both the coverage and the quality of FP services and practices.

Informed Choice of Contraceptive Methods among Women in Ethiopia: Further Analysis of the 2016 Ethiopian Demographic Health Survey.

BackgroundDelivering modern contraceptive methods only may not provide much insight into the quality of family-planning services. Informed choice emphasizes that clients select the method that best satisfies their needs by informing them about all available contraceptive methods, side effects of the methods, and how to deal with the side effects if experienced. This study investigated informed choice regarding contraceptives and associated factors among women in Ethiopia.MethodsData were extracted from the 2016 Ethiopian Demographic and Health Survey. Information on informed choice was extracted from the individual women’s data. Subjects comprised 3,511 (weighted) reproductive-age women aged 15–49 years using selected contraceptive methods. Bivariate and multivariate logistic regression models were used to assess factors associated with informed of contraceptive choice among women in Ethiopia. P<0.05 was considered statistically significant.ResultsOnly 36.2% of the participants were informed on contraceptive methods. Increased age, watching television less than once per week, and visiting health facilities in the last 12 months were associated with higher odds of being informed on contraceptive methods. Being affiliated with other religious groups, primary education only, having a husband employed in agriculture, being unskilled, with an unknown job, living in Amhara and Oromia regions, watching television at least once a week, and receiving the service from private clinics and pharmacies were associated with lower odds of being informed on contraceptive methods.ConclusionA substantial proportion of reproductive-age women in Ethiopia were inadequately informed about side effects or other methods. This varied by socio-demographic factors, sources of contraception, method, and frequency of visiting health institutions. This study suggests that interventions that increase family-planning counseling to the level that clients understand the methods are needed. Private health facilities also need to focus on delivering essential messages about methods they provide and assure women’s rights and choices.

The Validity of Women's Reports of Family Planning Service Quality in Cambodia and Kenya.

Population-based indicators of the coverage of key elements of high-quality family planning services are tracked via household surveys with female respondents, yet little work has been done to establish their validity. We take advantage of existing data sets from Cambodia and Kenya to compare women's responses at exit interviews following a health facility visit against the observations of a trained third-party observer during the visit. The results, which treat the observations as the reference standard, show that indicators that measure contraceptive methods received are accurately reported while indicators of whether the woman received her preferred method and whether information was "discussed" or "explained" during counseling are less reliably reported. Studies designed explicitly to assess the validity of family planning questions in household surveys, especially questions in large survey programs critical for monitoring demographic trends and programmatic coverage, are needed.

Community and health provider perspectives on the quality of family planning and contraceptive services in Kabwe District, Zambia

Quality family planning and contraceptive (FP/C) services result in positive outcomes such as client satisfaction and sustained use of contraceptives. While most assessments of quality in FP/C services are based on measurable reproductive health outcomes, there is limited consideration of the perspectives and experiences of health providers and community members. This study aimed to address this knowledge gap, by exploring health providers’ and community perspectives on the elements of quality FP/C services in Kabwe district, Zambia. Fourteen focus group discussions and 10 in-depth interviews were conducted in October–December 2016, involving community members, key community stakeholders such as religious and political leaders, health committee members and frontline and managerial healthcare providers. Data were analysed using a thematic approach. According to study participants, quality FP/C services would include provision by skilled personnel with positive attitudes towards clients, availability of preferred methods and affordable products. Additional factors included appropriate infrastructure, especially counselling services spaces and adequate consultation time. Participants stressed the need for reduced waiting time and opportunity for self-expression. The efficiency and effectiveness of service delivery factors, such as information dissemination and community engagement, were also considered important elements of quality FP/C. This study underscores the value of considering both community and health provider perspectives in efforts to improve the quality of FP/C services, with the overall aim of increasing client satisfaction and sustained utilisation. However, service delivery processes must also be addressed in addition to providing for community participation, if quality is to be achieved in FP/C services.

Quality of Long-acting Reversible Contraception Provision in Lomé, Togo.

ContextProvision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo’s modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to long-acting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo.MethodsData for this study were collected in 2016 as part of a larger research study conducted in Lomé, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake.ResultsOf the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48–2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61–2.51).ConclusionThis study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider–client information exchange is necessary to ensure women’s FP needs are met.

Task sharing in family planning in Burkina Faso: quality of services delivered by the delegate

Introduction:pour améliorer l’accessibilité des méthodes contraceptives au Burkina Faso, il a été initié un projet pilote de transfert des compétences de l’offre du DIU et de l’implant aux agents de santé première ligne (APL) ainsi que l’offre des méthodes contraceptives injectables aux agents de santé communautaire (ASC) dans 20 centres de santé du district sanitaire de Tougan. La présente étude visait à apprécier la qualité des services de planification familiale (PF) offerts par ces délégataires (APL et ASC).Méthodes:il s’est agi d’une étude transversale à visée descriptive et analytique. La collecte des données a combiné les méthodes quantitatives et qualitatives. Elle a porté sur l’ensemble des 20 centres de santé de la zone d’intervention du projet et sur tous les prestataires (54) impliqués dans l’offre des produits contraceptifs (délégants et délégataires). Dix-neuf (19) bénéficiaires dont 10 nouvelles utilisatrices d’une méthode contraceptive ont été interviewées. Les techniques de collecte étaient constituées de l’observation des prestations de services de PF et de l’environnement de travail, de la revue documentaire et des entretiens individuels. Les données ont été analysées à l’aide du logiciel Epi info 7 et Open Epi version 3.01. Le test du Chi carré et le test t de Student ont été utilisés pour déterminer s’il y existait une différence significative entre la qualité des services de PF offerts par les délégants et celle des délégataires.Résultats:le score de qualité générale du service de PF de la zone d’intervention était de 73% chez les délégataires contre 69% chez les délégants. Il n’y avait pas de différence statistiquement significative entre ces scores. Par contre, Il existait une différence statistiquement significative entre le score de qualité des agents de santé communautaire (75,8 %) et celui des délégants (87,5 %) en matière counseling (P <0.05). Il en était de même pour le score de qualité en matière de détermination des critères d’éligibilité des implants où la qualité chez les APL semble supérieure à celle des délégants: 79% pour les délégataires, 64% pour les délégants.Conclusion:cette expérience a eu l’avantage d’améliorer la couverture géographique de l’offre des méthodes contraceptives de longue durée d’action. Sous certaines conditions (renforcement des compétences, suivi, coaching), il est bien possible d’étendre l’offre des méthodes contraceptives de longues durées aux APL ainsi que celle des injectables aux ASC tout en conservant un niveau de qualité des services PF satisfaisant.

Structural Quality of Services and Use of Family Planning Services in Primary Health Care Facilities in Ethiopia. How Do Public and Private Facilities Compare?

Background: Family planning (FP) is among the important interventions that reduce maternal mortality. Poor quality FP service is associated with lower services utilisation, in turn undermining the efforts to address maternal mortality. There is currently little research on the quality of FP services in the private sector in Ethiopia, and how it compares to FP services in public facilities. Methods: A secondary data analysis of two national surveys, Ethiopia Services Provision Assessment Plus Survey 2014 and Ethiopian Demographic and Health Survey 2016, was conducted. Data from 1094 (139 private, 955 public) health facilities were analysed. In total, 3696 women were included in the comparison of users’ characteristics. Logistic regression was conducted. Facility type (public vs. private) was the key exposure of interest. Results: The private facilities were less likely to have implants (Adjusted Odds Ratio (AOR) = 0.06; 95% Confidence Interval (CI): 0.03, 0.12), trained FP providers (AOR = 0.23; 95% CI: 0.14, 0.41) and FP guidelines/protocols (AOR = 0.33; 95% CI: 0.19, 0.54) than public facilities but were more likely to have functional cell phones (AOR = 8.20; 95% CI: 4.95, 13.59) and water supply (AOR = 3.37; 95% CI: 1.72, 6.59). Conclusion: This study highlights the need for strengthening both private and public facilities for public–private partnerships to contribute to increased FP use and better health outcomes.

Measures of family planning service quality associated with contraceptive discontinuation: an analysis of Measurement, Learning & Evaluation (MLE) project data from urban Kenya.

Introduction: Several measures to assess family planning service quality (FPQ) exist, yet there is limited evidence on their association with contraceptive discontinuation. Using data from the Measurement, Learning & Evaluation (MLE) Project, this study investigates the association between FPQ and discontinuation-while-in-need without switching in five cities in Kenya. Two measures of FPQ are examined - the Method Information Index (MII) and a comprehensive service delivery point (SDP) assessment rooted in the Bruce Framework for FPQ. Methods: Three models were constructed: two to assess MII reported in household interviews (as an ordinal and binary variable) among 1,033 FP users, and one for facility-level quality domains among 938 FP users who could be linked to a facility type included in the SDP assessment. Cox proportional hazards ratios were estimated where the event of interest was discontinuation-while-in-need without switching. Facility-level FPQ domains were identified using exploratory factor analysis (EFA) using SDP assessment data from 124 facilities. Results: A woman's likelihood of discontinuation-while-in-need was approximately halved whether she was informed of one aspect of MII (HR: 0.45, p < 0.05), or all three (HR: 0.51, p < 0.01) versus receiving no information, when MII was assessed as an ordinal variable. Six facility-level quality domains were identified in EFA. Higher scores in information exchange, privacy, autonomy & dignity and technical competence were associated with a reduced risk of discontinuation-while-in-need (p < 0.05). Conclusions: The MII has potential as an actionable metric for FPQ monitoring at the health facility level. Furthermore, family planning facilities and programs should emphasize information provision and client-centered approaches to care alongside technical competence in the provision of FP care.

Measures of family planning service quality associated with contraceptive discontinuation: an analysis of Measurement, Learning & Evaluation (MLE) project data from urban Kenya

Introduction: Several measures to assess family planning service quality (FPQ) exist, yet there is limited evidence on their association with contraceptive discontinuation. Using data from the Measurement, Learning & Evaluation (MLE) Project, this study investigates the association between FPQ and discontinuation-while-in-need without switching in five cities in Kenya. Two measures of FPQ are examined – the Method Information Index (MII) and a comprehensive service delivery point (SDP) assessment rooted in the Bruce Framework for FPQ. Methods: Three models were constructed: two to assess MII reported in household interviews (as an ordinal and binary variable) among 1,033 FP users, and one for facility-level quality domains among 938 FP users who could be linked to a facility type included in the SDP assessment. Cox proportional hazards ratios were estimated where the event of interest was discontinuation-while-in-need without switching. Facility-level FPQ domains were identified using exploratory factor analysis (EFA) using SDP assessment data from 124 facilities. Results: A woman’s likelihood of discontinuation-while-in-need was approximately halved whether she was informed of one aspect of MII (HR: 0.45, p < 0.05), or all three (HR: 0.51, p < 0.01) versus receiving no information, when MII was assessed as an ordinal variable. Six facility-level quality domains were identified in EFA. Higher scores in information exchange, privacy, autonomy & dignity and technical competence were associated with a reduced risk of discontinuation-while-in-need (p < 0.05). Conclusions: The MII has potential as an actionable metric for FPQ monitoring at the health facility level. Furthermore, family planning facilities and programs should emphasize information provision and client-centered approaches to care alongside technical competence in the provision of FP care.