UPTAKE Local Principal Investigator, Gynaecologist, Department of Obstetrics and Gynaecology, Levy Mwanawasa Medical University (LMMU), Lusaka, Zambia.
UPTAKE Data Associate, Lecturer/Researcher, Department of Health Policy and Management, School of Public Health, University of Zambia, P.O Box 50110, Lusaka, Zambia. Correspondence:
Sex Reprod Health Matters. 2021 Dec;29(1):1985945. doi: 10.1080/26410397.2021.1985945.
Quality family planning and contraceptive (FP/C) services result in positive outcomes such as client satisfaction and sustained use of contraceptives. While most assessments of quality in FP/C services are based on measurable reproductive health outcomes, there is limited consideration of the perspectives and experiences of health providers and community members. This study aimed to address this knowledge gap, by exploring health providers' and community perspectives on the elements of quality FP/C services in Kabwe district, Zambia. Fourteen focus group discussions and 10 in-depth interviews were conducted in October-December 2016, involving community members, key community stakeholders such as religious and political leaders, health committee members and frontline and managerial healthcare providers. Data were analysed using a thematic approach. According to study participants, quality FP/C services would include provision by skilled personnel with positive attitudes towards clients, availability of preferred methods and affordable products. Additional factors included appropriate infrastructure, especially counselling services spaces and adequate consultation time. Participants stressed the need for reduced waiting time and opportunity for self-expression. The efficiency and effectiveness of service delivery factors, such as information dissemination and community engagement, were also considered important elements of quality FP/C. This study underscores the value of considering both community and health provider perspectives in efforts to improve the quality of FP/C services, with the overall aim of increasing client satisfaction and sustained utilisation. However, service delivery processes must also be addressed in addition to providing for community participation, if quality is to be achieved in FP/C services.
优质计划生育和避孕（FP/C）服务可带来积极结果，如客户满意和持续使用避孕方法。虽然大多数 FP/C 服务质量评估都基于可衡量的生殖健康结果，但对卫生提供者和社区成员的观点和经验考虑有限。本研究旨在通过探索赞比亚卡布韦地区卫生提供者和社区对 FP/C 服务质量要素的看法来填补这一知识空白。2016 年 10 月至 12 月期间进行了 14 次焦点小组讨论和 10 次深入访谈，涉及社区成员、宗教和政治领袖等主要社区利益相关者、卫生委员会成员以及一线和管理医疗保健提供者。使用主题方法对数据进行分析。根据研究参与者的说法，优质 FP/C 服务将包括由对客户持积极态度的熟练人员提供，提供首选方法和负担得起的产品。其他因素包括适当的基础设施，特别是咨询服务空间和充足的咨询时间。参与者强调需要减少等待时间和自我表达的机会。服务提供因素的效率和效果，如信息传播和社区参与，也被认为是 FP/C 优质服务的重要要素。本研究强调了在努力提高 FP/C 服务质量时考虑社区和卫生提供者观点的价值，总体目标是提高客户满意度和持续利用率。然而，如果要在 FP/C 服务中实现质量，除了提供社区参与外，还必须解决服务提供过程。
