Farrokh-Eslamlou Hamidreza, Aghlmand Siamak, Eslami Mohammad, Homer Caroline S E
Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, New South Wales, Australia and Reproductive Health Research Center, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
J Fam Plann Reprod Health Care. 2014 Apr;40(2):89-95. doi: 10.1136/jfprhc-2012-100290. Epub 2013 Aug 14.
We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran.
The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires.
Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05).
The adapted WHO's DMT has the potential to improve the quality of FP services.
我们调查了使用世界卫生组织（WHO）针对计划生育服务对象和提供者的决策工具（DMT）是否会改善伊朗计划生育（FP）服务的过程和结果质量指标。
DMT针对伊朗的情况进行了调整。该研究评估了24个FP质量关键指标，分为两个主要领域，即过程和结果。该工具在伊朗四个选定的代表性省份的52个城乡公共卫生机构中实施。采用前后对比方法来检验该工具的使用是否提高了FP服务的质量以及服务对象对服务的满意度。通过使用结构化问卷对咨询过程进行观察以及与服务对象进行离职访谈来收集定量数据。
在基线期和干预后期招募了不同数量的FP服务对象（分别为n = 448和547）。DMT改善了许多服务对象与提供者互动指标，包括言语和非言语沟通（p<0.05）。该工具还对服务对象避孕方法的选择、提供者的技术能力以及向服务对象提供的信息质量产生了积极影响（p<0.05）。使用该工具提高了服务对象对FP服务的满意度（从72%提高到99%；p<0.05）。
调整后的WHO的DMT有潜力提高FP服务的质量。
