肯尼亚西部公立医疗机构计划生育等待时间长的频率和影响。
Frequency and impact of long wait times for family planning in public-sector healthcare facilities in Western Kenya.
机构信息
Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Columbia University School of Nursing, New York City, NY, USA.
出版信息
Glob Health Action. 2022 Dec 31;15(1):2128305. doi: 10.1080/16549716.2022.2128305.
BACKGROUND
Long wait times for family planning services are a barrier to high quality care and client satisfaction. Existing literature examining family planning wait times has methodological limitations, as most studies use data collected during exit interviews, which are subject to recall, courtesy, and selection bias.
OBJECTIVE
We sought to employ a mixed methods approach to capture the prevalence, length, causes, and impacts of wait times for family planning services in Western Kenya.
METHODS
We used mystery clients, focus groups, key informant interviews, and journey mapping workshops to measure and describe family planning wait times. Fifteen mystery clients visited 60 public-sector facilities to quantitatively capture wait times. We conducted eight focus group discussions with 55 current or former family planning clients and 19 key informant interviews to understand facility-level barriers to family planning and feasible solutions. Finally, we visualized the process of seeking and providing family planning with journey mapping workshops with nine clients and 12 providers.
RESULTS
Mystery clients waited, on average, 74 minutes to be seen for family planning services. In focus group discussions and key informant interviews, three themes emerged: the nature of wait times, the impact of wait times, and how to address wait times. Clients characterized long wait times as a barrier to achieving their reproductive desires. Key informants perceived provider shortages to cause long wait times, which reduced quality of family planning services. Both providers and family planning clients suggested increasing staffing or offering specialization to decrease wait times and increase quality of care.
CONCLUSION
Our mixed methods approach revealed that wait times for family planning services were common, could be extensive, and were viewed as a barrier to high quality of care by clients, providers, and key informants. Across the board, participants felt that addressing workforce shortages would enhance service delivery and thus promote reproductive autonomy among women in Kenya.
背景
计划生育服务的长时间等待是高质量护理和客户满意度的障碍。现有的研究计划生育等待时间的文献存在方法学上的局限性，因为大多数研究使用在退出访谈中收集的数据，这些数据容易受到回忆、礼貌和选择偏差的影响。
目的
我们试图采用混合方法来捕捉肯尼亚西部计划生育服务等待时间的普遍程度、长度、原因和影响。
方法
我们使用神秘客户、焦点小组、关键知情人访谈和行程图工作坊来衡量和描述计划生育等待时间。十五名神秘客户访问了 60 个公共部门设施，以定量捕捉等待时间。我们进行了八次焦点小组讨论，参与者包括 55 名现任或前任计划生育客户和 19 名关键知情人，以了解计划生育方面的设施障碍和可行的解决方案。最后，我们通过与九名客户和十二名提供者一起进行行程图工作坊来可视化寻求和提供计划生育的过程。
结果
神秘客户平均等待 74 分钟才能获得计划生育服务。在焦点小组讨论和关键知情人访谈中，出现了三个主题：等待时间的性质、等待时间的影响以及如何解决等待时间。客户认为长时间的等待时间是实现他们生殖愿望的障碍。关键知情人认为人员短缺导致长时间的等待时间，从而降低了计划生育服务的质量。提供者和计划生育客户都建议增加人员配置或提供专业化服务，以减少等待时间并提高护理质量。
结论
我们的混合方法方法表明，计划生育服务的等待时间很常见，可能很长，并且被客户、提供者和关键知情人视为高质量护理的障碍。各方都认为，解决劳动力短缺问题将增强服务提供，从而促进肯尼亚妇女的生殖自主权。
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