Weidert Karen, Tekou Koffi B, Prata Ndola
Bixby Center for Population, Health and Sustainability, School of Public Health, University of California at Berkeley, Berkeley, CA, USA.
Centre d'Evaluation et de Suivi du Groupe de Recherche et d'Appui en Santé et Education de la Population, Lomé, Togo.
Open Access J Contracept. 2020 Sep 23;11:135-145. doi: 10.2147/OAJC.S257385. eCollection 2020.
Provision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo's modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to long-acting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo.
Data for this study were collected in 2016 as part of a larger research study conducted in Lomé, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake.
Of the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48-2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61-2.51).
This study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider-client information exchange is necessary to ensure women's FP needs are met.
提供高质量的避孕咨询和服务对于确保计划生育（FP）项目基于权利且自愿至关重要。多哥的现代避孕方法使用率稳步上升，近四分之一的方法组合归因于长效可逆避孕方法（LARC）。本研究的目的是评估多哥LARC服务的质量。
本研究的数据于2016年收集，作为在多哥洛美进行的一项更大规模研究的一部分，以评估现行FP服务提供模式的有效性。FP服务质量从项目能力和项目绩效方面进行评估。项目能力通过五个个体变量衡量，项目绩效通过方法信息指数（MII）衡量。描述性统计和混合效应模型用于评估采用LARC的可能性。
在纳入研究的669名客户中，19.4%采用了LARC方法。多变量结果显示，LARC的采用与过去三个月在机构的督导访视（项目能力指标）显著相关（OR 1.44；95%CI 1.48 - 2.39），即使在控制了提供者和客户特征后，MII评分呈阳性的人采用LARC的可能性也是其两倍（OR 2.1；95%CI 1.61 - 2.51）。
本研究确定督导访视和全面的避孕咨询是与LARC采用呈正相关的关键质量因素。持续关注护理质量和提供者 - 客户信息交流对于确保满足女性的FP需求是必要的。
