Asefa Tseganesh, Tesfaye Winta, Bitew Gedamnesh, Endale Hiwot Tezera
Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Front Reprod Health. 2025 Aug 29;7:1558606. doi: 10.3389/frph.2025.1558606. eCollection 2025.
Client satisfaction is a crucial indicator of family planning service utilization, and understanding these insights is essential for designing responsive, client-centered interventions to address barriers to contraceptive use. This study aimed to explore client satisfaction and determinants of family planning services in public health facilities in Debre Tabor town, northwest Ethiopia.
A convergent parallel mixed-methods design, incorporating both quantitative (facility-based cross-sectional) and qualitative (phenomenological) study approaches, was conducted at public health facilities in Debre Tabor town from April 15 to May 29, 2024. Data were collected using an interviewer-administered questionnaire following a multi-stage stratified random sampling technique. Simultaneously, qualitative data were collected from purposefully selected individuals using an in-depth interview guide. The study used EpiData version 4.6 for data input and SPSS version 25 for logistic regression analysis, using a -value < 0.05 as the cutoff point. After an in-depth interview, the record and field notes were transcribed, translated, and analyzed using a thematic analysis technique.
Out of 379 participants, 62.5% of clients were satisfied with the family planning services. Factors significantly associated with clients' satisfaction were urban residents (AOR = 1.68, = 0.022), government employees (AOR = 0.40, = 0.020), shorter waiting times (AOR = 2.93, = 0.039), method counseling (AOR = 2.32, = 0.005), and receiving the preferred method (AOR = 2.59, = 0.024). From the in-depth interview of 15 participants, two themes emerged: "limited provider-client counseling interaction," with subthemes of "cultural sensitivity gaps," "misconceptions," and "fear of ineffectiveness," and "pathways to satisfaction," with subthemes of "dignified care" and "accessibility."
The study found moderate client satisfaction with family planning services in public health facilities, with significant disparities in residence, occupation, waiting time, method counseling, and preferred methods. Clients reported a lack of cultural sensitivity, misconceptions, and a lack of involvement in decision-making. To improve satisfaction, health facilities should strengthen client-centered counseling, address cultural misconceptions, and provide flexible service hours and training for providers.
客户满意度是计划生育服务利用情况的关键指标，了解这些情况对于设计以客户为中心的针对性干预措施以消除避孕使用障碍至关重要。本研究旨在探讨埃塞俄比亚西北部德布雷塔博尔镇公共卫生设施中客户对计划生育服务的满意度及其决定因素。
2024年4月15日至5月29日，在德布雷塔博尔镇的公共卫生设施开展了一项采用定量（基于机构的横断面研究）和定性（现象学）研究方法相结合的收敛平行混合方法设计研究。采用多阶段分层随机抽样技术，通过访谈员协助的问卷收集数据。同时，使用深入访谈指南从有目的地挑选的个体中收集定性数据。本研究使用EpiData 4.6版本进行数据录入，使用SPSS 25版本进行逻辑回归分析，以P值<0.05作为截断点。深入访谈后，对记录和现场笔记进行转录、翻译，并采用主题分析技术进行分析。
在379名参与者中，62.5%的客户对计划生育服务感到满意。与客户满意度显著相关的因素包括城市居民（调整后比值比[AOR]=1.68，P=0.022）、政府雇员（AOR=0.40，P=0.020）、较短的等待时间（AOR=2.93，P=0.039）、方法咨询（AOR=2.32，P=0.005）以及获得首选方法（AOR=2.59，P=0.024）。在对15名参与者的深入访谈中，出现了两个主题：“提供者与客户咨询互动有限”，其子主题包括“文化敏感性差距”“误解”和“对无效性的恐惧”，以及“满意度途径”，其子主题包括“有尊严的护理”和“可及性”。
该研究发现公共卫生设施中客户对计划生育服务的满意度中等，在居住、职业、等待时间、方法咨询和首选方法方面存在显著差异。客户报告存在缺乏文化敏感性、误解以及缺乏参与决策的情况。为提高满意度，卫生设施应加强以客户为中心的咨询，消除文化误解，并为提供者提供灵活的服务时间和培训。
