Quality of family planning services in northwest Ethiopia

Abstract

Abstract
Background: The unmet need for family planning services in Ethiopia is believed to be high (36%) while the already available services do not appear to be optimally used by potential clients. It is thus expected that an assessment and improvement of the quality of family planning services could enhance family planning services utilization.
Objectives: The aim of this study is to assess the quality of family planning services provision in terms of clients’ perspectives, technical competence and interpersonal relations of providers and resources for the provision of effective family planning services.
Methods: A cross sectional study that employed exit interviews with clients, service - provider interviews, observations of client- provider interactions and an assessment of the availability of the necessary resources was conducted in one hospital, two health centers, two health stations, and one non-governmental clinic operating in north west Ethiopia.
Results: Two hundred seventy clients and 14 service providers were interviewed while another 86 client- provider interactions observations also made. The majority of the clients (66.3%) responded that there was no adequate privacy in service provision sessions. About 18% said that it was difficult to understand the service provider or that she or he did not hold any discussions at all. Communication and privacy was worse in government institutions compared to the NGO clinic included in this study (P<0.05). About 98.5% of the clients were not asked about STD risk and only 3.0% of the respondents were advised to use condoms. The providers mentioned several unjustified restrictions (like menstruation, age, marital status, husband’s consent) in which cases, they did not provide family planning methods. Deficiencies were also noted in the provision of information and communication with clients, infection prevention procedures, and adequacy and cleanliness of service giving facilities.
Conclusions: Several aspects of the quality of services observed by this study need to be improved and measures should also be taken to improve the provision of family planning services through training and maintaining adequate resources. [Ethiop.J.Health Dev. 2005;19(3):195-202]