Factors determining quality of care in family planning services in Africa

Tessema, Gizachew Assefa; Laurence, Caroline; Mahmood, Mohammad Afzal; Gomersall, Judith Streak

doi:10.11124/jbisrir-2016-003056

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…The review was based on published protocol [43] and followed established Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA reporting guidelines (S1 Table) [44]. …”

Section: Methodsmentioning

confidence: 99%

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

et al. 2016

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BackgroundImproving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa.MethodsQuantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings.ResultsFrom 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour.ConclusionThere is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries.

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“…The review was based on published protocol [43] and followed established Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA reporting guidelines (S1 Table) [44]. …”

Section: Methodsmentioning

confidence: 99%

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

et al. 2016

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“…And yet, the level of quality of family planning counseling is not well studied in the present study area. A few previous studies conducted in other study areas have identified a multitude of factors associated with the quality of family planning counseling [15][16][17][18][19][20][21][22]. However, most of these previous studies are aimed at assessing the quality of family planning counseling provided for women during prenatal care.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Family Planning Counseling Provided for Postpartum Women and Associated Factors

Abdulreshid

Dadi

2020

International Journal of Reproductive Medicine

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Background. Good quality family planning counseling particularly in the postpartum period is paramount to contraception adoption and continuation; it is also paramount in the reduction of maternal as well as infant morbidity and mortality. Objective. Assess the level of family planning counseling provided for women in their immediate postpartum period in the labor ward at Saint Paul’s Hospital in 2019. Method. An institution-based cross-sectional study was conducted from February to March of 2019 among women in the labor ward. A face-to-face exit interview was conducted with 209 randomly selected women. A structured pretested questionnaire was used to assess the level of family planning counseling provided. Bivariate logistic regression was used to test for statistical association. Results. Only 28.2% of the counseling sessions were adequate. Most (58.9%) of the counseling sessions did not maintain the privacy of the client. In 67.9% of the sessions, the counselor did not ask the concern of the client regarding the use of modern family planning methods and 74.2% of the clients were not told about the possible side effects of a method. Clients with no formal education (OR=2.52, 95%CI=1.1‐3.3) and those with only primary level education (OR=1.22, 95%CI=1.04‐3.02) were more likely to have had inadequate counseling. Conclusion. The level of family planning counseling was inadequate. The study indicated the need to provide training for service providers on family planning counseling with the existing standard frameworks but also in consideration of the sociodemographic background of the client, particularly their educational status.

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“…The findings of this study may be of significance in that, the providers may be a hindrance to the clients in ensuring they get the best quality care that is of benefit to them. Additionally, compromising the quality in turn may be of a disadvantage to the clients as evidenced in another study [22].…”

Section: Knowledge Of Service Providersmentioning

confidence: 94%

Factors affecting provision of female family planning commodities in public health facilities in Kajiado county, Kenya

Githinji

Maru

Karimi

et al. 2022

J of Pharm Policy and Pract

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Background Family planning involves the use of traditional or modern methods to prevent maternal and infant mortality associated with unintended pregnancies and negative economic outcomes. In sub-Saharan Africa, the unmet need for modern family planning is approximately 66%. However, information on factors affecting utilization of female family planning commodities is limited. Therefore, this research was conducted to bridge this gap. Methods Health facility-based descriptive cross-sectional research design was conducted and involved the public health facilities offering family planning, targeting respondents who handle the commodities and service providers themselves. A semi-structured questionnaire was used to collect data about availability of the commodities, knowledge of service providers and barriers affecting provision of the service. Data were coded and analyzed via Microsoft Excel 2019 and SPSS version 20. Results The study showed that shorter term methods were more readily available, 60–75% than the long-term methods, 20–60%. Approximately 60% of the service providers did not comprehensively utilize the recommended World Health Organization Medicine Eligibility Criteria (WHO MEC) during service provision. Stock outs, myths and misconceptions, male interference and culture were the major barriers identified. Conclusion Provision of family planning commodities in public health facilities in Kajiado county is affected by stock levels at the national program, and provider knowledge on WHO MEC. The key factors affecting provision of family planning were stock outs, myths and misconceptions on the contraceptives, inadequate male involvement and inadequate community engagement on potential benefits of the service. These challenges need to be part of the solutions to bridging the gap identified.

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Factors determining quality of care in family planning services in Africa

Cited by 10 publications

References 25 publications

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

Assessment of Family Planning Counseling Provided for Postpartum Women and Associated Factors

Factors affecting provision of female family planning commodities in public health facilities in Kajiado county, Kenya

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