Client-Centeredness of Family Planning Services in a Resource Limited Setting

Abstract

BACKGROUND: Clients’ needs and their satisfaction are priorityissues in studying quality in reproductive health services. However,only 24-37% of Ethiopian women were informed about theavailable family planning methods and their utilization. Highnational total fertility rate (4.8) and low contraceptive prevalencerate (29%) might be attributed to these and other reasons. Thisstudy assessed the level of client-centeredness of family planningservices and their determinants in public health facilities ofBahir Dar Town, Northwest Ethiopia.METHODS: Exit interviews of 326 consecutively enrolledclients were conducted using structured questionnaire. Thirtyconsultation sessions were observed using a checklist to recordclient-provider interaction. The outcome variable was clientcenteredness as measured by perceived informed choice withperceived client-provider interaction as the intermediate variable.RESULTS: The average levels of perceived informed choice andclient provider interaction were 70.0% and 67.6%, respectively.Perceived clinical competence of providers, perceived integrationand coordination of care, perceived accessibility of services,perceived participation of families and friends in care delivery,perceived physical comfort of the facilities and type of the healthfacility were the independent predictors of perceived clientproviderinteraction.Perceived degree of client providerinteraction, perceived clinical competence of providers, type ofhealth facility and perceived accessibility of services wereindependent predictors of perceived informed choice (p≤0.01).CONCLUSION: Client-centeredness of family planning services,as measured by clien- provider interaction and informed choicewas not sufficiently assured in the study facilities.