Tumlinson Katherine, Speizer Ilene S, Curtis Siân L, Pence Brian W
Postdoctoral Research Fellow, Office of Population Research, Princeton University, Wallace Hall, Princeton, NJ 08544..
Stud Fam Plann. 2014 Dec;45(4):443-70. doi: 10.1111/j.1728-4465.2014.00007.x.
In the field of international family planning, quality of care as a reproductive right is widely endorsed, yet we lack validated data-collection instruments that can accurately assess quality in terms of its public health importance. This study, conducted within 19 public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data-collection instruments used in large-scale facility surveys: provider interviews, client interviews, and observation of client-provider interactions. Results found low specificity and low positive predictive values in each of the three instruments for a number of quality indicators, suggesting that the quality of care provided may be overestimated by traditional methods of measurement. Revised approaches to measuring family planning service quality may be needed to ensure accurate assessment of programs and to better inform quality-improvement interventions.
在国际计划生育领域，作为一项生殖权利的护理质量得到了广泛认可，但我们缺乏能够从公共卫生重要性方面准确评估质量的经过验证的数据收集工具。这项在肯尼亚基苏木的19家公立和私立机构开展的研究，采用模拟客户法来测试大规模机构调查中使用的三种标准数据收集工具的有效性：对提供者的访谈、对客户的访谈以及对客户与提供者互动的观察。结果发现，对于一些质量指标，这三种工具中的每一种都具有较低的特异性和较低的阳性预测值，这表明传统测量方法可能高估了所提供护理的质量。可能需要修订测量计划生育服务质量的方法，以确保对项目进行准确评估，并为质量改进干预措施提供更充分的信息。
