Client-Centeredness of Family Planning Services in a Resource Limited Setting

Abstract

BackgroundClients' needs and their satisfaction are priority issues in studying quality in reproductive health services. However, only 24–37% of Ethiopian women were informed about the available family planning methods and their utilization. High national total fertility rate (4.8) and low contraceptive prevalence rate (29%) might be attributed to these and other reasons. This study assessed the level of client-centeredness of family planning services and their determinants in public health facilities of Bahir Dar Town, Northwest Ethiopia.MethodsExit interviews of 326 consecutively enrolled clients were conducted using structured questionnaire. Thirty consultation sessions were observed using a checklist to record client-provider interaction. The outcome variable was client centeredness as measured by perceived informed choice with perceived client-provider interaction as the intermediate variable.ResultsThe average levels of perceived informed choice and client provider interaction were 70.0% and 67.6%, respectively. Perceived clinical competence of providers, perceived integration and coordination of care, perceived accessibility of services, perceived participation of families and friends in care delivery, perceived physical comfort of the facilities and type of the health facility were the independent predictors of perceived client provider interaction. Perceived degree of client provider interaction, perceived clinical competence of providers, type of health facility and perceived accessibility of services were independent predictors of perceived informed choice (p≤0.01).ConclusionClient-centeredness of family planning services, as measured by clien-provider interaction and informed choice was not sufficiently assured in the study facilities.

Quality of care in sterilization services at the public health facilities in India: A multilevel analysis

“…It is very much essential to measure how well the client’s expectations, as well as providers’ technical standards and their adherence to those standards, are being met to ensure better quality services [ 52 ]. The quality of client-provider interaction, as perceived by clients, is a key to ensuring informed decision making in the delivery of family planning services [ 35 ]. Numerous barriers have kept policymakers, and researchers from taking a closer look at client-provider interactions, and more indicators are necessary for family planning program evaluation [ 33 , 34 ].…”

“…The client-provider interactions are the centerpiece of family planning programs, and it identifies appropriate ways to obtain information on how the service-delivery systems interact with people they are intended to serve [ 33 ]. It is crucial for improving the quality of family planning services and the most important independent predictor of informed choice among family planning clients [ 34 , 35 ]. However, other aspects of service delivery, such as access, availability, and the constellation of methods provided are also vital aspects of quality [ 36 ].…”

Early discontinuation of the IMPLANON® and associated factors in Ethiopia, systematic review and meta-analysis

“…But still, there are many women in Africa who live with the unmet need for family planning methods, discontinuation of the service, and non-use of service [ [26] , [27] , [28] ]. This is because the family planning service provided doesn't have quality in keeping privacy, provision of adequate information, and communication, to satisfy the need and expectations of the women [ 29 ].…”

Disparities in Long-Acting Reversible Contraceptive Utilization among Married Women in Ethiopia: Findings of the Ethiopian Demographic and Health Survey

“…Particularly, women's social status, access to education, and their involvement in decision making on reproductive matters, social norms regarding marriage, childbearing, and sexuality were found to be the major determinants of long-acting contraceptive use [5][6][7][8][9]. Furthermore, the capacity of health systems to provide quality and accessible family planning services greatly affects utilization of long-acting contraceptive methods [2,10]. However, these studies were conducted in specific geographic areas and had limited power to generalize the findings to the entire country.…”