Contraceptive prevalence is relatively high in Egypt with 56 percent of currently married women use a method according to the Egypt 2000 Demographic and Health Survey (El Zanaty and Way 2001). However, the family planning program is concerned about discontinuation rates showing that three in every 10 users stop using a method within the first 12 months of adoption. Evidence also suggests that the quality of care in Ministry of Health and Population (MOHP) clinics has improved and in many respects is quite good, yet some elements remain inadequate. A two-phase operations research study was launched in Egypt in early 2000 with the goal of demonstrating how improving the quality of client-provider interaction (CPI) could be achieved in large health care systems, specifically in relation to family planning. The study was designed to explore how CPI improvements could enhance family planning knowledge, method continuation rates, client satisfaction, and achievement of fertility goals. This study forms part of a global initiative conducted in comparable fashion in two other countries, Peru (León et al. 2003) and Uganda (Okullo et al. 2003). Research Questions The CPI study in Egypt has been designed to answer the following research questions: 1. Can measurable improvements be made in client-provider interaction by introducing practical systems-oriented, provider-oriented, and client-oriented interventions? 2. If client-provider interactions are improved, will there be measurable improvements in: (a) women's knowledge about available contraceptive choices; (b) women's satisfaction with contraception; (c) continued use of any method; (d) women's ability to obtain their preferred method (unless there is clear contraindication); (e) correct use of the chosen method; (f) prompt switching to another method; (g) women's ability to achieve their fertility goals or reproductive intentions (to delay a first birth, to space or to limit pregnancies); (h) increased numbers of new and continuing clients attending the clinic; and (i) a more diverse method mix in family planning clinics? 3. What is the impact of the intervention package on the job satisfaction of providers? 4. What are the costs of the various components of the intervention (training, technical assistance, additional monitoring, and client visits)? 5. Do the costs of carrying out family planning visits increase, and if so, by how much? Research questions (1), (3), (4) and (5) were investigated in Phase I of the study (SPAAC 2002). Research question (2) was examined through Phase II of the study (the present study) in which a cohort of new family planning acceptors was enrolled and followed-up for a period of 13 months after the index visit. Client outcomes were measured at seven and 13 months through home interviews.
This report analyzes the results of an operations research project carried out at two sites in Egypt to improve the medical care and counseling of postabortion patients. Preintervention and postintervention surveys and observations were conducted. After the introduction of vacuum aspiration under local anesthesia, the number of cases treated with dilatation and curettage under general anesthesia dropped from an average of 169 per month to 16. The majority of the remaining cases (an average of 119 per month) were treated with vacuum aspiration. Both providers' and women's knowledge about postabortion complications improved. Family planning information provided to postabortion patients increased as a result of the project's training program. The proportion of patients intending to use a contraceptive method increased by 30 percentage points due to the improved counseling. Future programs linking family planning and postabortion medical services should be prepared to improve the medical care of existing emergency health services and to add counseling services.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.