Quality of family planning services for women of reproductive age in Lao PDR

Abstract

Background: In Lao PDR, 15% of the married women want to postpone or prevent having a child, yet most are not using contraceptives to achieve this. Literature shows that usage of contraceptives is strongly dependent on the quality of family planning services. However, little is known about the quality of family planning services in Lao PDR. Objective: To assess the quality of family planning services provided in public health facilities in Lao PDR. Methods: Using a cross-sectional study design, public health facilities in three provinces in Lao PDR were assessed on structure, process and outcome measures of quality. Following the Quick Investigation of Quality approach, client exit interviews (n = 393), structured observations (n = 218) and facility audits (n = 17) were conducted. Results: Facility audits, observations and client exit interviews painted different pictures of the overall quality of family planning services. Taking all together, the quality was rated as moderate to high. Only marginal differences in quality were found between family planning services located in different geographical areas. Notably, only married women with children were using these services. Although contraceptives were provided, little attention was given to the information provided during consultations and to the interpersonal relationship between client and provider. Conclusion: The results suggest that although improvements are needed to enhance quality of individual consultations, the greatest gain in reducing unwanted pregnancies would be made by ensuring access for all women of reproductive age.

From ‘Pen Sao’ to ‘Tue Pa’: Understanding diverse pathways to adolescent pregnancy in Lao People’s Democratic Republic through qualitative investigation with girls in Vientiane Capital, Vientiane Province, and Luang Namtha

“…This aligns with similar research from the Philippines noting that even amid social disapproval of premarital sex, many young people engage in sexual relations before cohabitation or marriage [41,42]. Others have noted that while premarital sex is stigmatised and not socially accepted in Lao culture [12,17,34], in certain areas (i.e., rural, and rural-off-road) and ethnic minority communities, traditional values, beliefs, and practices are more permissive regarding adolescent premarital sexual relations [10,18,43].…”

“…Though there are no laws that explicitly prohibit young people from accessing SRH services [32], existing policies (e.g., 2019 National Sexual and Reproductive, Maternal, Newborn, Child and Adolescent Health Policy) lack specific guidance on parental consent requirements for minors to access contraceptives [33]. In the absence of laws or specific guidance, parental consent requirements are subject to healthcare providers' discretion [33], and recent research suggests that healthcare providers could be limiting adolescents' access to family planning services [34], especially since sex outside of marriage is socially unacceptable in Lao culture [12].…”

Kepuasan Akseptor Terhadap Pelayanan Pemasangan Kontrasepsi Implan Di Provinsi Banten Pasca Pandemi Covid-19

“…Kader KB dalam pelayanan kontrasepsi memiliki peran vital dalam pemberian komunikasi, informasi dan edukasi (KIE) secara rinci agar Pasangan Usia Subur (PUS) bersedia menggunakan kontrasepsi metode kontrasepsi jangka panjang dalam hal ini adalah kontrasepsi implan (Rusmin et al, 2019;Sulastri et al, 2019) (Danna et al, 2021;Rocca et al, 2021). Akseptor juga merasa penting mendapatkan informasi tentang kontrasepsi yang diberikan dan penggunaannya diberikan, walaupun di lapangan tidak selalu dilakukan dengan ideal seperti yang diharapkan oleh akseptor (Thongmixay et al, 2020). Kehandalan, perilaku, komunikasi, dan pendekatan yang tepat dari provider mempengaruhi nilai pelayanan dan kepuasan pengguna layanan kesehatan (Manzoor et al, 2019;Park et al, 2021;Reyes-Martí et al, 2021).…”

Improving the quality of family planning services in the Philippines: Barriers and opportunities

“…Other studies have identified a range of factors that can promote or inhibit QC for family planning. 6,7,[10][11][12][13][14][15][16][17] However, these prior studies sometimes focused only on clients' or providers' perspectives or used survey methods that assume the factors are known well enough to be limited to closed-ended survey questions. Most of these other studies were also conducted in other countries.…”