Quality of care in family planning services in Senegal and their outcomes.
Quality of care in family planning services in Senegal and their outcomes.
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DOI：
10.1186/s12913-017-2287-z
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发表时间：
2017-05-12
影响因子：
2.8
通讯作者：
Mallick L
中科院分区：
文献类型：
--
作者：
Assaf S;Wang W;Mallick L
计划生育服务的高质量护理与避孕方法的使用增加和持续有关。提供者的人际交往能力和技术能力是护理质量的主要组成部分之一。为了研究护理质量的过程组成部分，FP咨询主题的分布进行了检查的客户，提供者和设施的特点。为了评估护理质量的结果，客户满意度和他们的方法的保护性传播感染的知识。本研究探讨了与这些结果相关的因素，重点是提供者的咨询和培训。分析使用了2012-2013年塞内加尔服务提供评估调查的数据。调查包括塞内加尔卫生设施的代表性样本，并通过观察客户的计划生育访问和进行离职面谈来收集数据。感兴趣的主要结果是提供者的咨询计划生育，客户的满意度计划生育服务和客户的知识，他们的方法的保护性传播感染。在分析中使用了几个协变量，代表客户，提供者和设施的特点。咨询水平不足-提供不同类型咨询的提供者比例很低。咨询更有可能提供给新客户而不是回头客。大约84%的客户对服务非常满意，但只有58%的人正确了解其方法对性传播感染的保护。客户显着不太可能非常满意时，他们的供应商咨询的副作用和何时返回，并提供咨询方法的保护性传播感染并没有显着提高这方面的知识。与最近没有接受过培训的提供者相比，接受过FP培训的提供者所见的客户对他们的方法保护性传播感染有正确认识的几率几乎是接受过FP培训的提供者所见的客户的两倍。提供者提供计划生育咨询的客户的比例相对较低，是以客户为中心的结果无效。可能需要采取干预措施，以获得更有效的以客户为中心的咨询方法，并为提供者提供更多的FP培训。
High quality of care in family planning (FP) services has been found to be associated with increased and continued use of contraceptive methods. The interpersonal skills and technical competence of the provider is one of the main components of quality of care. To study the process component of quality of care, the distribution of the FP counseling topics was examined by client, provider and facility characteristics. To assess the outcomes of quality of care, client satisfaction and their knowledge of their method’s protection from STIs were used. This study examined the factors associated with these outcomes with a focus on provider counseling and training. Data from the 2012–2013 Senegal Service Provision Assessment survey was used for the analysis. The survey included a representative sample of the health facilities in Senegal and collects data by observing the clients’ FP visits and conducting exit interviews. The main outcomes of interest were provider’s counseling in FP, client’s satisfaction with FP services and client’s knowledge of their method’s protection from STIs. Several covariates were used in the analysis which represent client, provider and facility characteristics. The level of counseling was inadequate-- very low proportions of providers that performed different types of counseling. Counseling was more likely to be provided to new than returning clients. Approximately 84% of the clients were very satisfied with services but only 58% had correct knowledge of their method’s protection from STIs. Clients were significantly less likely to be very satisfied when their providers counseled on side effects and when to return, and counseling provided on method’s protection from STIs did not significantly improve knowledge in this area. Clients seen by a provider with FP training had almost twice the odds of having correct knowledge about their method’s protection from STIs compared with clients seen by a provider with no recent training. The percentage of providers offering FP counseling to their clients was relatively low and was ineffective on the client-focused outcomes. Interventions may be required for more effective counseling methods that are client-centered as well as providing more FP training to providers.