Changes in clients' perceptions of family planning quality of care in Kaduna and Lagos States, Nigeria: A mixed methods study.

Autor:	Akomolafe TO; Research Impact, Population Council, Abuja, Nigeria., OlaOlorun FM; Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria., Okafor E; Programs Department, Society for Family Health, Abuja, Nigeria., Baruwa S; Research Impact, Population Council, Abuja, Nigeria., Afolabi K; Reproductive Health, Federal Ministry of Health, Abuja, Nigeria., Jain A; Reproductive Health Program, Population Council, Washington DC, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in global women's health [Front Glob Womens Health] 2022 Nov 22; Vol. 3, pp. 1034966. Date of Electronic Publication: 2022 Nov 22 (Print Publication: 2022).
DOI:	10.3389/fgwh.2022.1034966
Abstrakt:	Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are crucial to improving access to family planning (FP) services in Nigeria. Although the private sector is preferred for convenience, availability of commodity, privacy, and timeliness, less well known is the quality of care received by clients who obtain FP services from CPs and PPMVs. This paper seeks to explore the use of validated quality of care measures for programming in Kaduna and Lagos States and to assess how these measures worked in capturing changes in quality of care using client exit interviews implemented at two time points. Using validated measures of quality of care, 598 and 236 exit interviews in rounds 1 and 2 were conducted with FP clients aged 18-49 years old. The quality of care domains were assessed using 22 questions. A weighted additive quality score was created, and scores were grouped into three: low, medium, and high quality. Changes in quality of care received were examined using χ 2 test. A subset of 53 clients were selected for in-depth interviews. Deductive and inductive approaches were used for coding, and data analysis was thematic. In Lagos, we observed increases in 16 out of 22 items while in Kaduna increases were only observed in 8 items. For instance, increases were observed in the proportion of women who experienced visual privacy between rounds 1 and 2 in Lagos (74%-89%) and Kaduna (66%-82%). The quality of care received by clients changed over time. Women who reported high quality care in Lagos increased from 42% to 63%, whereas women who reported high quality care in Kaduna decreased from 35% to 21%. In both states, in-depth interviews revealed that women felt they were treated respectfully, that their sessions with providers were visually private, that they could ask questions, and that they were asked about their preferred method. This study demonstrates that clients received high quality of care services from providers (CPs and PPMVs) especially in Lagos, and such services can be improved over time. Continuous support may be required to maintain and prevent reduction in quality of FP counseling and services, particularly in Kaduna. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2022 Akomolafe, Olaolorun, Okafor, Baruwa, Afolabi and Jain.)
Databáze:	MEDLINE
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