Winston Jennifer, Calhoun Lisa M, Guilkey David, Macharia Peter M, Speizer Ilene S
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Department of Economics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Glob Womens Health. 2023 Mar 30;4:1117849. doi: 10.3389/fgwh.2023.1117849. eCollection 2023.
Quality of care and physical access to health facilities affect facility choice for family planning (FP). These factors may disproportionately impact young contraceptive users. Understanding which components of service quality drive facility choice among contraceptive users of all ages can inform strategies to strengthen FP programming for all potential users of FP.
This study uses data from Population Services International's Consumer's Market for Family Planning (CM4FP) project, to examine drivers of facility choice among female FP users. The data collected from female contraceptive users, the outlet where they obtained their contraceptive method, and the complete set of alternative outlets in select urban areas of Kenya and Uganda were used. We use a mixed logit model, with inverse probability weights to correct for selection into categories of nonuse and missing facility data. We consider results separately for youth (18-24) and women aged 25-49 in both countries.
We find that in both countries and across age groups, users were willing to travel further to public outlets and to outlets offering more methods. Other outlet attributes, including signage, pharmacy, stockouts, and provider training, were important to women in certain age groups or country.
These results shed light on what components of service quality drive outlet choice among young and older users and can inform strategies to strengthen FP programming for all potential users of FP in urban settings.
医疗服务质量以及前往医疗机构的实际可达性会影响计划生育（FP）机构的选择。这些因素可能对年轻的避孕药具使用者产生不成比例的影响。了解服务质量的哪些组成部分驱动着所有年龄段避孕药具使用者的机构选择，可为加强针对所有计划生育潜在使用者的计划生育规划策略提供参考。
本研究使用了国际人口服务组织的计划生育消费者市场（CM4FP）项目的数据，以考察女性计划生育使用者中机构选择的驱动因素。所收集的数据包括女性避孕药具使用者、她们获取避孕药具方法的机构，以及肯尼亚和乌干达部分城市地区的完整替代机构集合。我们使用混合逻辑模型，并采用逆概率权重来校正未使用类别和缺失机构数据的选择偏差。我们分别考虑了两国中青少年（18 - 24岁）和25 - 49岁女性的结果。
我们发现，在两国以及所有年龄组中，使用者都愿意前往更远的公共机构以及提供更多方法的机构。其他机构属性，包括标识、药房、缺货情况和提供者培训，对某些年龄组的女性或某些国家的女性来说很重要。
这些结果揭示了服务质量的哪些组成部分驱动着年轻和年长使用者的机构选择，并可为加强城市环境中所有计划生育潜在使用者的计划生育规划策略提供参考。
