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Rebecca Wind
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QUALITY OF CONTRACEPTIVE SERVICE PROVISION DIFFICULT TO MEASURE

A review of studies from the past two decades reveals that the quality of family planning services women receive affects their contraceptive behavior, according to “The Quality of Family Planning Services in the United States: Findings from a Literature Review,” by Davida Becker et al., published in the December 2007 issue of Perspectives on Sexual and Reproductive Health. However, the authors found only 29 studies of family planning service quality released between 1985 and 2005; further, they found that a lack of consistency in the measures assessed makes it difficult to compare the various studies’ findings regarding the quality of services or the impact of those services on women’s contraceptive behavior.

On the basis of the available information, the authors infer that, if services are not of high quality, clients may not receive the information or learn the skills they need to adopt and sustain successful contraceptive behavior. The available studies assessed a range of components of service delivery including relations between clients and service facility staff, communication, patient-centeredness and efficiency. Several studies reported that to clients, the most important aspects of family planning service delivery are receiving personalized attention, having staff who spend enough time explaining issues, being able to see the same provider at different visits, receiving care that is technically appropriate and receiving affordable care. In addition, several studies identified barriers to services, including long waits, inconvenient hours of operation, difficulty reaching providers by phone and unavailability of appropriate language interpretation services.

The authors identify a need for further research, guided by a universal definition of high-quality family planning service and a conceptual framework. Specifically, they suggest borrowing from the international family planning literature a definition of high-quality service care that offers clients “a range of services that are safe and effective and that satisfy clients’ needs and wants.”

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