The Situation Analysis Study of the Family Planning Program in Kenya

Miller, Robert A.; Ndhlovu, Lewis; Gachara, M; Fisher, Andrew

doi:10.2307/1966641

Cited by 45 publications

(23 citation statements)

References 15 publications

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“…In a study carried out in urban and rural areas of Khartoum state, contraceptive pills were the most frequently used method, followed by intrauterine devices and injections (Ibnouf et al 2007). In Kenya, the most frequently used method was contraceptive pills, followed by injectables and IUDs (Miller et al 1991).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of maternal and child health services in El-Minia City, Egypt

et al. 2009

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Background Primary health-care centers provide outpatient health care and primary preventive activities for people in general and for mothers and children in particular. Medical care aims not only to improve health status, but also to respond to patients' needs and wishes and to ensure their satisfaction with care. The patient-clinician relationship is a central feature of primary care.Objective The purpose of this study was firstly determining the utilization pattern of Maternal and Child Health (MCH) services in urban and rural health centers in El-Minia City and secondly identifying factors affecting client dissatisfaction with the services provided by the two centers. Design Cross-sectional study. Method The study is a cross-sectional descriptive study conducted among two MCH centers randomly selected in El Minia City (MCH); this study included 400 female clients, 200 from each center. An anonymous questionnaire was designed by the research team to assess the performance of the provided services as well as client satisfaction. The client satisfaction part of the questionnaire included five items: waiting time, environment, doctor-client interaction, nurse-client interaction, and economic feasibility. Assessment of client satisfaction was done using a scoring system rated by three levels of response categories: satisfied, accepted, and dissatisfied. Pareto charts were drawn according to the frequency of each category showing the level of 80% cumulative percentage as cutoff, which identifies the corresponding factors related to dissatisfaction.Results The study showed that the rural center had a higher frequency of attendance regarding the curative services, antenatal care (ANC), and delivery care, while the urban center had higher attendance for family planning services, despite higher utilization of the rural center; histories of abortion and under-5-year moralities were more prevalent among customers of the rural center than those of the urban center, and clients of the urban center reported more satisfaction than those of the rural one. The most common causes of dissatisfaction were long waiting time and improper environment. Nearly 15% of the deliveries of babies in the rural center were attended by non-skilled personnel, and about half of the clients of the family planning section used intrauterine devices as a method of contraception. Conclusion MCH centers provide many services for mothers and their children, and the majority of the clients were satisfied with the services. However, the most common reason for dissatisfaction was the long waiting time.Recommendations include encouraging and rewarding any health facility that fulfills a high rate of attendance and client satisfaction, and reduction of waiting time. Attention should be directed to the environmental conditions of the rural center.

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Section: Discussionmentioning

confidence: 99%

Evaluation of maternal and child health services in El-Minia City, Egypt

et al. 2009

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“…Kenya’s first nationwide assessment of family planning quality was conducted in 1989 among 99 randomly selected public facilities; this study found several deficiencies in service quality including restricted choice of methods, little information on management of side effects, failure on the part of providers to ascertain the client’s reproductive goals, and a dearth of mechanisms in place to ensure follow-up [10]. Results from a subsequent study in 1993, focusing on public facilities in Nairobi, did not differ markedly from the national study [11].…”

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confidence: 99%

Quality of Care and Contraceptive Use in Urban Kenya

Tumlinson¹,

Pence²,

Curtis³

et al. 2015

International Perspectives on Sexual and Reproductive Health

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CONTEXT Family planning is highly beneficial to women’s overall health, morbidity, and mortality, particularly in developing countries. Yet, in much of sub-Saharan Africa, contraceptive prevalence remains low while unmet need for family planning remains high. It has been frequently hypothesized that the poor quality of family planning service provision in many low-income settings acts as a barrier to optimal rates of contraceptive use but this association has not been rigorously tested. METHODS Using data collected from 3,990 women in 2010, this study investigates the association between family planning service quality and current modern contraceptive use in five cities in Kenya. In addition to individual-level data, audits of select facilities and service provider interviews were conducted in 260 facilities. Within 126 higher-volume clinics, exit interviews were conducted with family planning clients. Individual and facility-level data are linked based on the source of the woman’s current method or other health service. Adjusted prevalence ratios are estimated using binomial regression and we account for clustering of observations within facilities using robust standard errors. RESULTS Solicitation of client preferences, assistance with method selection, provision of information by providers on side effects, and provider treatment of clients were all associated with a significantly increased likelihood of current modern contraceptive use and effects were often stronger among younger and less educated women. CONCLUSION Efforts to strengthen contraceptive security and improve the content of contraceptive counseling and treatment of clients by providers have the potential to significantly increase contraceptive use in urban Kenya.

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“…The need for systematic, reliable, and relatively fast measures of quality gave rise to the development of a set of instruments known as the Situation Analysis (Simmons and Elias, 1994). As the first attempt to operationalize the concept of quality (Miller et al, 1991), the objectives of the situation analysis were to describe both the quality and infrastructure of family planning services and to evaluate the impact of quality on the outcomes of client satisfaction, realization of reproductive goals, contraceptive prevalence, and fertility (Fisher et al, 1992). …”

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confidence: 99%

“…The Hawthorne effect results during third party observations for which providers display their “best behavior” (MEASURE Evaluation, 2001, Bessinger and Bertrand, 2001). For example, during a situation analysis conducted in Kenya in 1991, a provider reported, “I usually do not have this much time for clients, but in view of your presence, I had better try to do an especially good job ” (Miller et al, 1991). Lastly, when interviewing family planning clients just before they exit the health facility, clients may have difficulty recalling the information that they received during their family planning counseling session, resulting in recall bias.…”

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confidence: 99%

Accuracy of Standard Measures of Family Planning Service Quality: Findings from the Simulated Client Method

Tumlinson

Speizer

Curtis

et al. 2014

Studies in Family Planning

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Despite widespread endorsement within the field of international family planning regarding the importance of quality of care as a reproductive right, the field has yet to develop validated data collection instruments to accurately assess quality in terms of its public health importance. This study, conducted among 19 higher volume public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data collection instruments included in large-scale facility surveys: provider interviews, client interviews, and observation of client-provider interactions. Results found low specificity and positive predictive values in each of the three instruments for a number of quality indicators, suggesting that quality of care may be overestimated by traditional methods. Revised approaches to measuring family planning service quality may be needed to ensure accurate assessment of programs and to better inform quality improvement interventions.

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The Situation Analysis Study of the Family Planning Program in Kenya

Cited by 45 publications

References 15 publications

Evaluation of maternal and child health services in El-Minia City, Egypt

Evaluation of maternal and child health services in El-Minia City, Egypt

Quality of Care and Contraceptive Use in Urban Kenya

Accuracy of Standard Measures of Family Planning Service Quality: Findings from the Simulated Client Method

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