Quality of the contraceptive service structure: A pilot study in Finnish health centre organisations

Sannisto, Tuire; Saaristo, Vesa; Ståhl, Timo; Mattila, Kari; Kosunen, Elise

doi:10.3109/13625187.2010.500750

Cited by 4 publications

(4 citation statements)

References 24 publications

(29 reference statements)

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“…Concordantly with the providers’ perspective in our study, research shows that the development of health facility policies and establishing internal standards for the provision of ASRH could be instrumental in coordinating efforts at the managerial level and provider level (28). Our findings indicate that the elaboration of procedures concerning ASRH services in particular may encompass issues, such as registration and confidentiality.…”

Section: Discussionsupporting

confidence: 62%

Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

Jaruševičienė

Orozco

Ibarra

et al. 2013

Global Health Action

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ObjectivesTo elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved.MethodsOverall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology.ResultsStudy participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers’ awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become ‘gate-openers’ to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts.ConclusionsTo improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level.

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Section: Discussionsupporting

confidence: 62%

Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

Jaruševičienė

Orozco

Ibarra

et al. 2013

Global Health Action

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“…The teams and their departments needed more than the QIC's 8 months duration to see the desired effect of several changes. This included the time to receive support from leadership to make changes in clinical practice [27,28] regarding access to LARC [26]. In our study, support from leadership, including time for training, was fundamental to enable fast track access for LARC insertion within 10 days post abortion.…”

Section: Discussionmentioning

confidence: 98%

Examining the pace of change in contraceptive practices in abortion services – a follow-up case study of a quality improvement collaborative

Kilander

Brynhildsen

Alehagen

et al. 2020

BMC Health Serv Res

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Background Among all women who experienced an abortion in Sweden 2017, 45% had previously underwent at least one abortion. This phenomenon of increasing rates of repeat abortions stimulated efforts to improve contraceptive services through a Quality Improvement Collaborative (QIC) with user involvement. The participating teams had difficulty in coordinating access post-abortion to the most effective contraception, Long-acting reversible contraception (LARC), during the eight-month QIC. This prompted questions about the pace of change in contraceptive services post-abortion. The aim of the study is to evaluate the evolution and impact of QIC changes regarding patient outcomes, system performance and professional development over 12 months after a QIC designed to enhance contraceptive services in the context of abortion. Methods This follow-up case study involves three multi-professional teams from abortion services at three hospitals in Sweden, which participated in a QIC during 2017. We integrated qualitative data on the evolution of changes and quantitative data regarding the monthly proportion of women initiating LARC, analysed in statistical control charts from before the QIC up until 12 months after its conclusion. Results Teams A and B increased the average proportion of women who initiated LARC within 30 days post abortion in the 12 months after the QIC; Team A 16–25%; Team B 20–34%. Team C achieved more than 50% in individual months but not consistently in the Post-QIC period. Elusive during the QIC, they now could offer timely appointments for women to initiate LARC more frequently. Team members reported continued focus on how to create trustful relationships when counseling women. They described improved teamwork, leadership support and impact on organizing appointments for initiating LARC following the QIC. Conclusions QIC teams further improved women’s timely access to LARC post abortion through continued changes in services 12 months after the QIC, demonstrating that the 8-month QIC was too short for all changes to materialize. Teams simultaneously improved women’s reproductive health, health services, and professional development.

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“…The teams experienced differing support from their local leadership (study IV). These factors are very likely to affect women's access to LARC [172] and might explain why some women experience repeat UPs and abortions. Moreover, even if choice of LARC is the most effective method for preventing repeat abortions, as found in study I, coordinated access to LARC is still not fully achieved in clinical practice, according to study IV.…”

Section: General Findingsmentioning

confidence: 99%

“…This thesis highlights the importance of support from managers, when seeking to improve counselling and prevent repeat UPs in abortion services (study IV). Sannisto et al [172] found that the quality of contraceptive services was associated with the quality of leadership [172], mirroring implementation research more broadly [173]. PCC needs to be applied at all levels of healthcare organisation, from the head of department to the team, to facilitate PCC in the meetings between women and HPs, as well as coordinated access to care [131,138], including at the time of an abortion.…”

Section: General Findingsmentioning

confidence: 99%

Contraceptive counselling in abortion care

Kilander

2018

Linköping University Medical Dissertations

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Introduction Improving women's knowledge about contraception, and their access to contraceptive methods, is central in order to strengthen their sexual and reproductive rights at the time of an abortion. Contraceptive counselling aims to support women's reproductive control and prevent unintended pregnancies (UPs). It is unclear, however, how to provide contraceptive counselling and how to organise services at the time of an abortion, in order to achieve this.

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Quality of the contraceptive service structure: A pilot study in Finnish health centre organisations

Abstract: In the majority of the HCOs involved, the quality of service structure was rated average, but there was much variation between the HCOs. The results of the multivariate analysis emphasise the importance of good management of services.

Cited by 4 publications

References 24 publications

Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

Examining the pace of change in contraceptive practices in abortion services – a follow-up case study of a quality improvement collaborative

Contraceptive counselling in abortion care

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