A woman is more likely to be using contraceptives up to two years after her first family planning visit if she receives high-quality care at that visit, according to "The Link Between Quality of Care And Contraceptive Use," by Saumya RamaRao, of the Population Council, et al. In particular, women who receive high-quality care are more likely to continue using a modern method--two thirds of women who rated their experience highly were using the pill, injectable, IUD, condom or sterilization at follow-up, as compared with about half of women who received low-quality care.
To assess the impact of women's first family planning experiences, researchers interviewed 1,728 new family planning users in the Philippines in 1997-1998 and, beginning 16 months later, gathered follow-up data from the same women to determine if they were still practicing contraception. After her first appointment, each woman scored her visit on five essential dimensions of care-giving:
• Needs assessment (was she asked about whether she wanted to have children, how long she would like to wait before having her next child, and her previous family planning experiences),
• Method choices (was she asked which method she preferred, told about at least one other method and given her method of choice),
• Information received (was she shown how her adopted method works, told how to use her adopted method, warned of potential side effects, etc.),
• Interpersonal relations (was she allowed to ask questions, treated in a friendly manner, shown respect, etc.), and
• Continuity of care (was a follow-up visit scheduled, was she informed of alternative sources of care, given an appointment card showing the date of a follow-up visit).
The dramatically increased odds of continued contraceptive use at follow-up after high-quality care support the generally accepted notion that good interpersonal relationships between women and their health care providers can improve services. In addition, by identifying these five categories of care and specifying the actions involved in each, RamaRao and colleagues highlight some key factors to consider in creating effective reproductive health programs. Their research points to a well-rounded information exchange during a woman's first family planning visit, going beyond advocating friendly provider-patient relations to demand clear explanations of all options and all risks after a thorough examination of the patient's specific needs.
The article appears in the June 2003 issue of International Family Planning Perspectives.
Also in this issue:
"Women's Networks and the Social World of Fertility Behavior," by Sangeetha Madhavan, University of theWitwatersrand, South Africa; Alayne Adams, Columbia University's Mailman School of Public Health, New York; and Dominique Simon, Health and Addictions Research, Boston, MA.
"Impact and Determinants of Sex Preference in Nepal," by Tiziana Leone and Zoe Matthews, University of Southampton, UK; and Gianpiero Dalla Zuanna, Universita di Padova, Italy.
"Knowledge and Perception of Emergency Contraception Among Female Nigerian Undergraduates," by Michael E. Aziken, Patrick I. Okonta and Adedapo B. A. Ande, University of Benin Teaching Hospital, Nigeria.