MEASURING THE QUALITY OF FAMILY PLANNING SERVICE DELIVERY IN URBAN KENYA Public Deposited

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  • March 19, 2019
Creator
  • Tumlinson, Katherine
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Abstract
  • Family planning saves lives but is underutilized in developing countries. Improvements in the quality of family planning service delivery may lead to increased contraceptive prevalence; however the association between quality and family planning use has not been well established. Additionally, the validity of standard instruments used to measure the quality of family planning service delivery is unknown. This research used the simulated client method and original data collected from family planning service providers and clients at 19 health facilities in Western Kenya to test the validity of standard facility-level data collection instruments. This research also estimated the association between quality of care and family planning use in urban Kenya using individual (n=3,990 women) and facility-level (n=260 facilities) cross-sectional data collected in 2010-2011 by the Measurement, Learning & Evaluation Project. Results of the validation analysis found that all three standard instruments used to measure family planning service quality performed poorly when compared to the referent standard of simulated client data. This suggests that revised approaches to measuring family planning service quality may be needed to ensure accurate assessment of programs and to better inform quality improvement interventions. Additionally, the multivariate analysis found that the consistent availability of an appropriate mix of contraceptive methods as well as provision of information by providers on side effects and provider treatment of clients are all associated with significant increases in the likelihood of current modern contraceptive use. This suggests that efforts to strengthen contraceptive security and improve the content of contraceptive counseling and treatment of clients by providers have the potential to significantly increase contraceptive use in urban Kenya.
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  • In Copyright
Advisor
  • Siega-Riz, Anna Maria
  • Marshall, Stephen
  • Pence, Brian
  • Speizer, Ilene
  • Curtis, Sian
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2014
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  • Chapel Hill, NC
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