Addressing socio-cultural barriers to family planning and co-designing services to improve utilization: evidence from northern Nigeria

Abstract

BACKGROUND: Family planning is a proven cost-effective intervention that has contributed to women empowerment and overall human development. Demand factors and women’s expectations and experiences at health facility for family planning services may influence their uptake and utilisation of these services. Increased awareness and positive community perception and quality of family planning services that meet clients’ expectations may greatly improve utilization. The aim of this study was to identify ways to improve family planning service users' experience at primary health care centres towards improving utilization of family planning services in two northern Nigerian states. METHODS: This qualitative study was part of a larger operations research that explored married women’s and service providers’ perception of quality of care along the RMNCH pathway to inform improvements in service delivery. The study utilised Experience-based co-design (EBCD) methodology that employed qualitative methods to explore clients and service providers’ experiences of healthcare services. A total of 92 IDIs and 4 FGDswere conducted in two communities each in Kano and in Yobe states. ‘Touch points’ from service providers’ and respondents’ experiences were extracted using thematic analysis. Joint workshops were further conducted with clients and providers to co-design a user-driven service pathway to improve service utilization. RESULTS: Key 'touch points' from providers’ experiences included stock out of family planning commodities, inadequate equipment and infrastructure and cultural and religious believes that prevent utilization of family planning services. In addition, clients reported challenges securing husband permission to utilize services, poor provider attitude and lack of female providers at health facility as obstacles to service utilization. Co-designing a service improvement plan by service providers and clients that involved increasing community awareness about the benefits of family planning by service providers, improving providers’ attitude, increasing family planning outreach and promoting men involvement in family planning programmes. CONCLUSION: EBCD provides a platform that make clients active contributors to family planning service improvement plans at the health facility thereby ensuring provision of quality services that meet the need of women.

Identifying Barriers to Utilization of Basic Emergency Obstetric and NewBorn Care Services in Jigawa State, North-western Nigeria: A Qualitative Study

“…Similarly, a study from Nigeria also reported that the majority of the women can identify obstetric danger signs. 12 On the contrary, studies carried out in Northern 13 and another study from Ethiopia 14 reported a low level of identification of obstetric danger signs.…”

Reframing Patient Experience Approaches and Methods to Achieve Patient-Centeredness in Healthcare: Scoping Review

“…After screening the title and abstract of 6183 papers (excluding duplicates) for relevance to the subject, 131 papers were selected. A total of 67 articles [ 1 , 7 , 12 , 13 , 14 , 15 , 16 , 17 , 21 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , …”