Family Planning in Nairobi: A Situation Analysis of the City Commission Clinics

Bs, Mensch; Ra, Miller; Aa, Fisher; Mwita, John Isaac; Keyonzo, N; Fy, Ali; C, Ndeti

doi:10.2307/2133434

Cited by 10 publications

(6 citation statements)

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“…2 A situation analysis of Nairobi clinics showed that fewer than 50% of new clients w e re provided with information on contraindications to or side effects of their chosen method. 3 Further situation analyses conducted in 12 African countries indicated that the percentage of clients informed about both how to use their method and its potential side effects ranged from lows of 5% in Tanzania and 22% in Burkina Faso, to highs of 64% in Kenya and 68% in B o t s w a n a . 4 In a similar study conducted P e ru, for example, some nonpro f e s s i o n a l Ministry of Health personnel explained that they had not been trained, while others were reluctant to give full information about a method because they doubted that clients would understand its mode of action, or because they did not want to scare o ff the client with talk about side eff e c t s .…”

Section: Length Of Counseling Sessions and The Amount Of Relevant Infmentioning

confidence: 99%

Length of Counseling Sessions and the Amount of Relevant Information Exchanged: A Study in Peruvian Clinics

León¹,

Monge²,

Zumaran³

et al. 2001

International Family Planning Perspectives

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International Family Planning Perspectives in Ecuador, Uganda and Zimbabwe, fewer than 75% of clients in each country were given any information about the contraceptive method they re c e i v e d . 5 Results are no diff e rent when the specific content of counseling is examined. For example, to probe how well clients w e re being counseled about when and how to switch methods, a study carried out in the coastal province of Santa, Peru , used simulated clients who had recently initiated pill use and who complained of headaches. Of the 54 Ministry of Health p roviders who were approached, more than 25% failed to tell the client that the headaches might be a side effect of pill use, and more than 30% did not tell her that they might disappear shortly. 6 In a similar study based on a national sample of 25 hospitals and 74 clinics in Ecuador, 47% of providers failed to tell the client that her headaches might be a side effect of the pill, and 61% neglected to inform her that they might go away with time. 7 When confronted with such evidence of incomplete counseling, providers generally attribute their shortcomings to causes beyond their control. In rural areas of Federico R. León is program associate with the Fro n t i e r s in Reproductive Health program of the Population Council, Lima, Peru. At the time this re s e a rch was conducted, Rosa Monge was a consultant, Adriana Zumarán was an intern, Ingeborg García was an intern and Alex Ríos was a re s e a rch assistant, all at the Population Council, Lima. The authors thank Lucy López for her comments on the study tools, Jorge Parra for his help in facilitating access to the health centers and John Townsend and Cynthia G reen for their useful comments on earlier drafts of this article. The re s e a rch upon which this article was based was made possible by funding from the U.S. Agency for International Development (USAID) under cooperative a g reement HRN-A-00-98-0012-00 with the Population Council. The opinions expressed herein are those of the authors and do not necessarily re flect the view of USAID. Length of Counseling Sessions and the Amount Of Relevant Information Exchanged: A Study in Peruvian ClinicsBy Federico R. León, Rosa Monge, Adriana Zumarán, Ingeborg García and Alex Ríos T he concept of "informed choice" in family planning counseling implies that providers assist clients in selecting the method that best satisfies their needs, and that clients leave the session knowing about the side effects of their chosen method and how to use it safely and eff e c t i v e l y. 1 Worldwide, however observational findings suggest that actual counseling is far from meeting these requirements.Audiotaped counseling sessions in Kenya, for example, revealed that only 57% of clients receiving the injectable and 32% of those getting the pill were provided with information on their method's side eff e c t s . 2 A situation analysis of Nairobi clinics showed that fewer than 50% of new clients w e re provided with information on contraindications to or side effects of thei...

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Section: Length Of Counseling Sessions and The Amount Of Relevant Infmentioning

confidence: 99%

Length of Counseling Sessions and the Amount of Relevant Information Exchanged: A Study in Peruvian Clinics

León¹,

Monge²,

Zumaran³

et al. 2001

International Family Planning Perspectives

View full text Add to dashboard Cite

show abstract

“…

Choice of Methods . Choice of methods is determined by the physical availability of a satisfactory selection of methods as well as willingness on the part of the provider to discuss multiple methods and to ascertain client preferences [11].

Information Given to Clients .

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Section: Methodsmentioning

confidence: 99%

“…Kenya’s first nationwide assessment of family planning quality was conducted in 1989 among 99 randomly selected public facilities; this study found several deficiencies in service quality including restricted choice of methods, little information on management of side effects, failure on the part of providers to ascertain the client’s reproductive goals, and a dearth of mechanisms in place to ensure follow-up [10]. Results from a subsequent study in 1993, focusing on public facilities in Nairobi, did not differ markedly from the national study [11]. …”

mentioning

confidence: 99%

Quality of Care and Contraceptive Use in Urban Kenya

Tumlinson¹,

Pence²,

Curtis³

et al. 2015

International Perspectives on Sexual and Reproductive Health

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CONTEXT Family planning is highly beneficial to women’s overall health, morbidity, and mortality, particularly in developing countries. Yet, in much of sub-Saharan Africa, contraceptive prevalence remains low while unmet need for family planning remains high. It has been frequently hypothesized that the poor quality of family planning service provision in many low-income settings acts as a barrier to optimal rates of contraceptive use but this association has not been rigorously tested. METHODS Using data collected from 3,990 women in 2010, this study investigates the association between family planning service quality and current modern contraceptive use in five cities in Kenya. In addition to individual-level data, audits of select facilities and service provider interviews were conducted in 260 facilities. Within 126 higher-volume clinics, exit interviews were conducted with family planning clients. Individual and facility-level data are linked based on the source of the woman’s current method or other health service. Adjusted prevalence ratios are estimated using binomial regression and we account for clustering of observations within facilities using robust standard errors. RESULTS Solicitation of client preferences, assistance with method selection, provision of information by providers on side effects, and provider treatment of clients were all associated with a significantly increased likelihood of current modern contraceptive use and effects were often stronger among younger and less educated women. CONCLUSION Efforts to strengthen contraceptive security and improve the content of contraceptive counseling and treatment of clients by providers have the potential to significantly increase contraceptive use in urban Kenya.

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“…Because this coincided with the responses of most of the clients interviewed as they exited the clinic, the correlation between client and observer perceptions was extremely high (k = 0.98). Studies using the situation analysis technique, which yields reports from direct observers, also confirm that most clients are treated by providers in a friendly manner (Mensch et al 1994).…”

mentioning

confidence: 87%

Challenging the Courtesy Bias Interpretation of Favorable Clients’ Perceptions of Family Planning Delivery

et al. 2007

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Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three countries. Providers excelled in courteousness/respect in Peru and Rwanda; in India, providers were less courteous and respectful when the simulated clients chose the pill. Privacy and two-way communication were less prevalent in all three countries. The findings challenge the courtesy bias interpretation. Global results from qualitative studies may have expressed the views of the minority of clients who are not treated well by providers.

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Family Planning in Nairobi: A Situation Analysis of the City Commission Clinics

Cited by 10 publications

References 1 publication

Length of Counseling Sessions and the Amount of Relevant Information Exchanged: A Study in Peruvian Clinics

Length of Counseling Sessions and the Amount of Relevant Information Exchanged: A Study in Peruvian Clinics

Quality of Care and Contraceptive Use in Urban Kenya

Challenging the Courtesy Bias Interpretation of Favorable Clients’ Perceptions of Family Planning Delivery

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