Department of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Kenya Medical Research Institute, Nairobi, Kenya.
Pan Afr Med J. 2021 Apr 19;38:380. doi: 10.11604/pamj.2021.38.380.24055. eCollection 2021.
this study assessed the availability of family planning (FP) services in the social franchise and non-franchise private health facilities in Kajiado County, Kenya. Social franchises refer to a standardized delivery model of engaging private health facilities under a common brand name or contractual arrangement.
this was a facility-based mixed-method approach. Quantitative data was collected through 581 FP client exit interviews and a facility inventory in 32 health facilities. Association between the clients' characteristics and use of FP services was tested using univariable and multivariable logistic regression. Qualitative data were collected through five focus group discussions with FP clients and 16 key informant interviews with service providers and analysed through thematic analysis.
the findings show that FP methods availability was the same across all facilities (p = 0.206). The findings were supported by views from the clients who indicated that contraceptives were available. Statistically significant predictors of FP use were found to be women's age group 20-24 years (Adjusted Odds Ratio (AOR) = 2.30, 95% Confidence Interval (CI): 1.12, 4.69) or 25 to 34 years (AOR = 2.10, 95% CI: 1.86, 2.36) versus the 15-19 years and the clients with tertiary level education and above compared primary level education and below (AOR = 0.020, 95% CI: 1.13, 4.41).
this study demonstrates the need to support all private health facilities with policies and supplies to expand access to all FP services, especially for adolescents.
本研究评估了肯尼亚卡贾多县社会特许经营和非特许经营私立卫生机构提供计划生育(FP)服务的情况。社会特许经营是指通过共同品牌名称或合同安排,使私营卫生机构参与标准化服务提供的模式。
本研究采用基于机构的混合方法。通过对 32 家卫生机构的 581 名 FP 客户退出访谈和设施清单收集定量数据。使用单变量和多变量逻辑回归检验客户特征与 FP 服务使用之间的关联。通过对 FP 客户的 5 个焦点小组讨论和对服务提供者的 16 个关键知情人访谈收集定性数据,并通过主题分析进行分析。
研究结果表明,所有设施的 FP 方法可用性相同(p=0.206)。这一发现得到了客户观点的支持,他们表示避孕药具是可用的。 FP 使用的统计学显著预测因素被发现是女性年龄组 20-24 岁(调整后的优势比(AOR)=2.30,95%置信区间(CI):1.12,4.69)或 25-34 岁(AOR=2.10,95%CI:1.86,2.36)与 15-19 岁和具有高等教育及以上学历的客户与具有小学及以下学历的客户相比(AOR=0.020,95%CI:1.13,4.41)。
本研究表明,需要为所有私立卫生机构提供政策和供应支持,以扩大所有 FP 服务的获取机会,特别是为青少年提供服务。