Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

Abstract

Despite decades of emphasis on quality of care, qualitative research continues to describe incidents of poor quality client–provider interactions in family planning provision. Using an emerging framework on disrespect and abuse (D and A) in maternal health services, we reviewed the global published literature for quantitative tools that could be used to measure the prevalence of negative client experiences in family planning programs. The search returned over 7,000 articles, but only 12 quantitative tools included measures related to four types of D and A (non-confidential care, non-dignified care, non-consented care, or discrimination). We mapped individual measurement items to D and A constructs from the maternal health field to identify measurement gaps for family planning. We found significant gaps; current tools are not adequate for determining the prevalence or impact of negative client experiences in family planning programs. Programs need to invest in tools that describe all aspects of client experiences, including negative experiences, to increase accountability and maximize the impact of current investments in family planning programs.

WITHDRAWN: Do provider behaviors influence client satisfaction of family planning services in Togo? Evidence from a cross-sectional facility survey

“…In addition, since this study relies on secondary data that did not originally set out to measure client satisfaction, the client satisfaction outcome developed was based on only ve questions and reliability tests indicated weakness with the measure, which led us to adopt a single proxy measure for client satisfaction as an outcome. Future studies should consider adopting a more robust measure of satisfaction such as the 12-item indicator described by Wang et al (2014) (32) and the 10-item indicator described by Jain et al (2019) (33) and should consider including better indicators of client's negative experience (34). It might also be useful to incorporate measures that consider whether or not the client will return or refer a friend or family member to the same provider and to incorporate mixed method study designs so that quantitative ndings particularly surrounding client-provider interactions can be further explained (35).…”

Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity

“…The connection with the SDGs is unclear, and the final sentence describing the framework is also unclear to me. Additional resources that could be engaged with/cited in the paper: Dennis, A., Blanchard, K., & Bessenaar, T. (2017) 1 Harris S, et al (2016) 2 …”

Adaptation and validation of social accountability measures in the context of contraceptive services in Ghana and Tanzania

“…The measures also speak to another gap in understanding the poor quality of care still reported in contraceptive services [ 1 , 15 , 37 ]. Harris et al [ 15 ] argue that current tools do not adequately determine the prevalence or impact of negative client experiences in contraceptive programs and that current measures can de-emphasise and misdirect attention from client experiences of coercion, corruption, and disrespect and abuse when they come for family planning. The scale, ‘Mistreatment by health workers’, responds to this gap and by better capturing all dimensions of patients’ experience, we can learn what is working, or not, in terms of quality of care [ 2 ].…”