Determinants of client satisfaction with family planning services in public health facilities of Jigjiga town, Eastern Ethiopia

What are the associated factors of low husbands/partners independent decision-maker in women's contraceptive use decision-making process in Ethiopia? Multilevel analysis

BACKGROUND

Many married women of reproductive age with husbands or partners are less cooperative in using contraceptives, often resulting in unintended pregnancies or secret contraceptive use. This private use of contraceptives causes women to suffer from side effects without proper support, and many women in Ethiopia die due to unintended pregnancies. However, the involvement of husbands or partners in the contraceptive decision-making process in Ethiopia is often neglected. There is also a lack of evidence regarding the determinants of husbands' or partners' decision-making power on contraceptive use in Ethiopia.

OBJECTIVE

This study aimed to assess the determinants of low involvement of husbands/partners in women's contraceptive use decision-making processes in Ethiopia.

METHODS

This study was based on Ethiopian Demographic and Health Survey data, collected from January 18 to June 27, 2016. Weighted samples of 3,669 reproductive-age women were included. Husbands'/partners' independent decision-making was measured by whether the husband/partner decided independently or alone about contraceptive use, categorized as "Yes" or "No". A multilevel logistic regression model was fitted, and ICC (Intra-class Correlation Coefficient), MOR (Median Odds Ratio), PCV (Proportion Change in Variance), and deviance were used to assess model fitness and comparison. Variables with a p-value of ≤ 0.2 in the bivariate analysis were considered candidates for multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval was used to determine both the direction and strength of the association, and a p-value of < 0.05 was used to declare statistical significance.

RESULTS

Husbands'/partners' independent decision-making in women's contraceptive use was found to be 5.41% [4.72-6.19%]. Significant factors associated with this included: Husbands/partners aged 31-59 years (Adjusted Odds Ratio (AOR) = 1.3; Confidence Interval (CI) 2.3-5.4) and over 59 years (AOR = 2.3; CI 1.2-4.3), Educational level of husbands/partners: primary education (AOR = 3.2; CI 2.9-4.3), secondary education (AOR = 3.9; CI 2.7-4.4), and higher education (AOR = 4.3; CI 2.8-5.0), Media exposure (AOR = 4.5; CI 2.2-5.4), History of pregnancy termination (AOR = 3.3; CI 2.6-4.1), Perception that distance to health facilities is not a significant problem (AOR = 3.0; CI 1.7-4.7) and Urban residency (AOR = 3.5; CI 1.6-4.2).

CONCLUSIONS

In Ethiopia, the involvement of husbands/partners in the contraceptive use decision-making process is low. To increase their decision-making power, attention should be given to factors such as age, educational level, media exposure, history of pregnancy termination, distance to health facilities, and urban residency.

Client satisfaction on family planning, its myths, and misconceptions among women in Wolaita zone, Southern Ethiopia: A mixed methods design

Background

Client satisfaction has been recognized as an essential component in evaluating healthcare quality. In Wolaita Zone, there was a lack of research on the myths, misconceptions, and elements linked to client satisfaction with family planning. This study aimed to assess the myths and misconceptions of family planning and the factors associated with women's satisfaction with family planning services.

Methods

We used a mixed methods study design (cross-sectional study design with a phenomenological design of the qualitative study). For the survey, 777 women were selected using multistage sampling, while purposive sampling was used to recruit in-depth interview participants. We used STATA version 15 and NVIVO version 12 software.

Results

Only two-thirds, 534 (68.7 %) [95 % CI = 65.4%-71 %] clients, were satisfied with the family planning service. Clients who attended secondary education and above (AOR = 1.84; 95 % CI: 1.07, 3.23) and (AOR = 3.04; 95 % CI: 1.37, 6.72) did not wait to get the service (AOR = 5.11; 95 % CI: 1.98, 13.20), attended family planning service in a facility with convenient working hours (AOR = 4.43; 95 % CI: 2.25-8.74) and with posters in the waiting room (AOR = 3.48; 95 % CI: 1.22-9.94), comfortable with the cleanliness of clinic (AOR = 2.08; 95 % CI: 1.20, 3.94), whose Privacy was maintained (AOR = 9.56; 95 % CI: 5.02, 18.20), who were given information on the possible side effects of a method (AOR = 2.77; 95 % CI: 1.75-4.39), and on how the method works (AOR = 2.57; 95 % CI: 1.49-4.43) had higher odds of satisfaction. Also, various myths and misconceptions, such as implants moving to other parts of the body, implants causing paralysis, affecting routine activities, "womb of the woman may not hold the baby", etc., were identified in a qualitative study.

Conclusions

Client satisfaction in this study is low. An improved provider approach that suits on-site advocacy and the quality of counselling during the family planning service is needed. There is also a need to improve waiting time, working hours, cleanliness, awareness creation for both couples, and maintaining clients' privacy.

Level of client satisfaction among family planning service users in semi-pastoralist areas of Southeast Ethiopia: a mixed-methods study

Background

Client satisfaction with family planning services is a crucial metric for gauging healthcare providers' performance. There is a dearth of local data that explores the factors that influence clients' satisfaction with family planning services in semi-pastoral areas using a mixed-methods approach. This study aimed to assess the level of client satisfaction and its associated factors among family planning service users in six public health centers in Southeast Ethiopia.

Methods

A multi-centered, concurrent, mixed-method survey using quantitative and qualitative methods was conducted in six public health centers in Southeast Ethiopia from March 15 to April 16, 2022. Four hundred nineteen systematically selected family planning method users and their respective six family planning service providers were approached using a purposive sampling technique. A multivariable binary logistic regression model was used to identify the independent factors associated with clients' satisfaction with family planning services.

Results

Four hundred fourteen study participants were finally approached, and client satisfaction with family planning services in those centers was 57.5% with a 95% CI of 52.71%-62.71%. Being in the age group of 25-34 years (AOR = 1.99; 95% CI 1.2, 3.29), married (AOR = 2.41; 95% CI 1.13, 5.15), waiting less than 30 min (AOR = 1.74; 95% CI 1.11, 2.72), and receiving the family planning method they want (AOR = 2.35; 95% CI 1.16, 4.76) were positively associated with client satisfaction. Updating the provider's skills and knowledge, keeping clients' method choices, and leaving free decisions also increased client satisfaction.

Conclusions

In this study, client satisfaction with family planning services remains low. Users' age, marital status, waiting time, and wish to receive the method they want were positively associated with client satisfaction.

Understanding adolescent girls' experiences with accessing and using contraceptives in Zambia

BACKGROUND

Globally, the unmet need for contraception among adolescent girls is high and is driven by barriers to access and utilisation of contraceptives. Understanding adolescent girls' experiences with accessing and using contraceptives is crucial because it influences their decision to use and willingness to continue using health products and services. While determinants of contraceptive use have been extensively researched globally, few studies explore how adolescent girls experience contraceptive use in Zambia using qualitative methods. Therefore, this study aimed to understand Zambian adolescent girls' experiences using contraceptives.

METHODS

Thematic analysis was used to analyse data generated from 7 focus group discussions and three in-depth interviews with adolescent girls aged 15 to 19 years in 4 districts in Zambia. NVivo version 12 pro (QSR International) software was used to manage and organise the data.

RESULTS

Results revealed that adolescents' experiences concerning contraceptives across the continuum of care are shaped by various factors, including knowledge of contraceptives which comprises sources of information and contraceptives; experience with using contraceptives, challenges with access to contraceptives, and misconceptions about contraceptives; perspectives about existing contraceptives; and preferred types of contraceptives.

CONCLUSION

The multifactorial interaction relating to adolescents' personal experience, their community and the environment in which they access contraceptive services all contribute to their overall experience and influence their contraceptive decisions. Therefore, qualitative studies exploring adolescents' experiences with accessing and using contraceptives are vital for tailoring interventions responsive to the contraceptive needs of this age group.

Quality of family planning services and associated factors among reproductive age women attending family planning unit at public health facilities in Dire Dawa, Eastern Ethiopia, 2021

INTRODUCTION

Improving the quality of care has been a necessary goal for family planning programs worldwide. Even though extensive work has been done, the contraceptive prevalence rate is still low (41% in Ethiopia, 30.5% in Dire Dawa) and the unmet need for contraception is high (26%) in Ethiopia. Moreover, quality of care in family planning services has an important role in increasing coverage of services and program sustainability. Therefore, the objective of this study was to assess quality of family planning services and associated factors among reproductive age women attending family planning unit in public health facilities in Dire Dawa, Eastern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among reproductive-age women attending a family planning unit in Dire Dawa, Eastern Ethiopia, from September 1-30/2021. A total of 576 clients were selected by systematic random sampling and interviewed using a pre-tested structured questionnaire. SPSS version 24 was used to analyze the data, which included descriptive statistics, bi-variable and multivariable logistic regression analyses. To determine the presence of an association between dependent and independent variables, AOR, P-value 0.05, and 95% CI were used.

RESULTS

A total of 576 clients participated in the study and provided a response rate of 99%. The overall satisfaction of clients with FP services was 79%[95% CI:75.2%, 82.9%]. Having primary education (AOR = 2.11, 95% CI(1.11-4.24), convenient facility opening hours (AOR = 3.13, 95% CI (2.12-5.75), maintaining privacy (AOR = 4.1, 95% CI(2.50-8.12), demonstrating how to use F/P method (AOR = 1.98, 95% CI (1.01-5.20), and discussing F/P issues with husbands (AOR = 5.05, 95% CI: 3.33-7.64) were positively significantly associated with client satisfaction.

CONCLUSION AND RECOMMENDATION

This study revealed that about four-fifth of the clients was satisfied with the service they received. Clients' education, facility opening hour, maintained privacy, discussion with husband, and demonstration of how to use the methods were associated with client satisfaction. Therefore, health facility heads should improve facility opening hour. Health care providers should maintain client privacy every time, and should consistently utilize information, education, and communication materials during consultation sessions by giving more attention to client who has no education. Partner's discussion on family planning issues should also be encouraged.

Prevalence and associated factors of client satisfaction with family planning service among family planning users in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Considering the importance of client satisfaction in the quality of family planning services, a regular evaluation should be carried out. Several studies have been conducted in Ethiopia, but so far there were no pooled estimates of the prevalence of customer satisfaction with family planning services in the country. Therefore, this systematic review and meta-analysis was intended to estimate the pooled prevalence of client satisfaction with Ethiopian family planning services in Ethiopia. The findings of the review can be used to develop strategies and draft policies in the country.

METHODS AND MATERIALS

This review included articles published only in Ethiopia. The main databases were Medline/PubMed, Web of Science, Google Scholar, Scopus, Ethiopian University Repository Online, and Cochrane Library. Cross-sectional studies conducted in English and meeting the eligibility criteria were included in the review. A random-effects meta-analysis was performed. Data extraction and analysis were performed using Microsoft Excel and STATA version 14 software, respectively.

RESULT

The pooled prevalence of customer satisfaction with family planning services in Ethiopia was 56.78% [(95% CI (49.99, 63.56); I² = 96.2%, p < 0.001]. Waiting time > 30 min [OR = 0.2, 95% CI (0.1-0.29), I² = 75.0%, p < 0.001], privacy maintained [OR = 5.46, 95% CI (1.43-20.9), I² = 95.8%, p < 0.001], education status [OR = 0.47], 95% CI (0.22-0.98), I² = 87.4%, p < 0.001] was significant in client satisfaction related to family planning services.

CONCLUSION

According to this review, client satisfaction with family planning services in Ethiopia was 56.78%. In addition, waiting time, women's educational level, and respect for privacy were identified as factors that both positively and negatively impact women's satisfaction with family planning services. Decisive action, such as educational intervention, continued monitoring and evaluation of family planning services, and arranging training for providers, is required to address identified issues and ensure higher levels of family satisfaction and utilization. This finding is important for shaping strategic policies and improving the quality of family planning services. This finding is important for designing strategic policy and increasing the quality of family planning services.

Evaluation of family planning service delivery in Gondar city public health facilities, Northwest Ethiopia: A cross-sectional study

Introduction

Family planning program is low-cost and an effective way to lower maternalmortality by reducing the number of high-risk births. Despite the effectiveness of the program, availability of materials, equipment and trained healthcare providers were some of the challenges in sub-Saharan African countries including Ethiopia. Determining the implementation status and identifying gaps is the aim of this evaluation.

Method

A facility-based cross-sectional evaluation design with mixed method approach was employed. Quantitative data was collected through the exit interview of 477 clients from March 25-April 25, 2020. The evaluation focused on three dimensions: availability, compliance, and acceptability with multiple data sources. The quantitative data were entered in to Epi-data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done to determine factors associated with client satisfaction. The qualitative data were transcribed, translated and analyzed by using thematic analysis. The evaluation finding was computed and compared with the preset criteria for the final judgment.

Result

The majority of the health care providers (69.8%) got family planning training in the past two years. Three health facilities (37.5%) had 24hrs electricity with backup generators whereas only 25% of the health facilities had functional piped water inside the service room. Only two (25%) health facilities had a separate room for family planning service and 37.5% of health facilities had national FP guidelines. The overall availability of required resources for family planning service at Gondar city public facilities were 62.1%. Only twenty one (26.3%) of health providers dressed based on dressing code of ethics and none of them had ID during our observation. The overall compliance level of health care providers during providing family planning services were 75.5%. About 53.9% of the clients were satisfied with family planning service provided at Gondar city public health facilities.—and–were significantly associated variables with client satisfaction.

Conclusion

The overall implementation of family planning service in Gondar city public health facilities with the three evaluation dimensions were judged as fair based on pre-setting judgment matrix. It is better to improve the service through training of healthcare providers, distributed family planning guidelines to health facilities and shortening of waiting time for service.

Perceptions and Degree of Satisfaction with the Health Sciences University Educational Community Regarding the Measures Adopted for the Prevention of COVID-19 in the Academic Year 2020/2021

The COVID-19 pandemic caused the start of the academic year 2020/2021 to be conditioned by health and safety regulations. The present research was defined with the aim of analyzing the degree of satisfaction and perceptions on the establishment of bubble groups and pairs and on the use of audiovisual platforms for the development of theoretical and practical university teaching in three degrees of health sciences. A cross-sectional descriptive study was carried out on a representative sample of students and teachers of health sciences in Ponferrada (n = 285). Specific questionnaires designed for this study were completed virtually during April and May 2021. The results indicate that that satisfaction was moderate-high. The perception of the influence of bubble pairs on the quality of teaching can be interpreted as very low. These results increase with the age and academic and professional experience of students and faculty members, respectively. However, the participants belonging to physiotherapy considered that the quality of teaching had worsened much more compared to their counterparts in nursing and podiatry.

Newly evolving pastoral and post-pastoral rangelands of Eastern Africa

Over the past two decades, the rangelands of Eastern Africa have experienced sweeping changes associated with growing human populations, shifting land use, expanding livestock marketing and trade, and greater investment by domestic and global capital. These trends have coincided with several large shocks that were turning points for how rangeland inhabitants make a living. As livelihoods in the region's rangelands transform in seemingly paradoxical directions, away from customary pastoralist production systems, greater insight is required of how these transformations might affect poverty and vulnerability. This article reviews the state of what is known regarding directions of livelihood change in the rangelands of Eastern Africa, drawing on case studies of structural change in five settings in the region. It considers the implications of long-term change, as well as the emergence of very different livelihood mixes in pastoral rangelands, for efforts to reduce poverty and vulnerability in these places.

Client Satisfaction with Family Planning Services and Associated Factors in Tembaro District, Southern Ethiopia

INTRODUCTION

Client satisfaction influences the use of family planning and other reproductive health services. This study aimed to assess the magnitude of client satisfaction with family service and its associated factors among reproductive-age women.

PATIENTS AND METHODS

We conducted a facility-based cross-sectional study. A total of 411 clients, nested in four health facilities, were included in the analysis. Systematic sampling was employed to select study units for the exit interview. Data collection instruments for this study were pre-tested structured questionnaires. Client satisfaction was assessed using fifteen Likert-scaled question items. Each item of question has 5 points ranging from 1 (strongly disagree) to 5 (strongly agree) and, finally, mean was computed. The pre-coded data were entered into Epi Data version 4.2.0 and exported to SPSS version 25 for analysis. Logistic regression analysis was carried out to identify independently associated factors at a confidence interval of 95% and a significance level of p-value less than 0.05.

RESULTS

Magnitude of client satisfaction with family planning service was 46% [95% CI: 41-50.8]. Rural residence [AOR=3.07; 95% CI: 1.10-8.62], educational level of college and above [AOR=0.22; 95% CI: 0.07-0.70] as compared to the educational level of primary education, waiting time of less than half an hour [AOR=7.80; 95% CI: 2.48-24.48], maintaining privacy [AOR=7.16; 95% CI: 2.89-17.69], describing side effects of methods [AOR=3.14; 95% CI: 1.02-9.76] were factors significantly associated with client satisfaction.

CONCLUSION

The overall magnitude of client satisfaction with the services was found to be low. Many of the factors that attributed to the low level of client satisfaction are modifiable. There is a need for organizing the family planning room as per standards, maintaining privacy, minimizing waiting time, and describing the side effects during the provision of service.

Quality of family planning services for women of reproductive age in Lao PDR

BACKGROUND

In Lao PDR, 15% of the married women want to postpone or prevent having a child, yet most are not using contraceptives to achieve this. Literature shows that usage of contraceptives is strongly dependent on the quality of family planning services. However, little is known about the quality of family planning services in Lao PDR.

OBJECTIVE

To assess the quality of family planning services provided in public health facilities in Lao PDR.

METHODS

Using a cross-sectional study design, public health facilities in three provinces in Lao PDR were assessed on structure, process and outcome measures of quality. Following the Quick Investigation of Quality approach, client exit interviews (n = 393), structured observations (n = 218) and facility audits (n = 17) were conducted.

RESULTS

Facility audits, observations and client exit interviews painted different pictures of the overall quality of family planning services. Taking all together, the quality was rated as moderate to high. Only marginal differences in quality were found between family planning services located in different geographical areas. Notably, only married women with children were using these services. Although contraceptives were provided, little attention was given to the information provided during consultations and to the interpersonal relationship between client and provider.

CONCLUSION

The results suggest that although improvements are needed to enhance quality of individual consultations, the greatest gain in reducing unwanted pregnancies would be made by ensuring access for all women of reproductive age.

Rural Resident Experience on National Basic Public Health Services: A Cross-Sectional Survey in 10 Western Provinces of China

National basic public health services (BPHSs) are important for promoting the health of rural populations. A better understanding of rural BPHSs from the viewpoint of residents utilizing the services can help health-related departments and primary health care (PHC) centers further improve rural BPHSs. By conducting a large-scale cross-sectional survey in 10 western provinces of China, the study depicts rural resident experiences with rural BPHSs. Of the 9019 participants, 59.33% and 66.48% did not receive services related to health examinations or health education in the six months prior to the survey, respectively. A total of 56.90% were satisfied with the rural BPHSs, and the mean overall satisfaction score was 3.61 ± 0.908 (out of a maximum of 5). The most satisfying domain for rural residents with BPHSs was the attitude of PHC workers, whereas rural residents with chronic diseases were the least satisfied with the health management. Satisfaction with the attitude of PHC workers was identified as the strongest determinant of rural residents’ overall satisfaction with BPHSs. This study could enlighten rural BPHSs management in China.