Provider imposed restrictions to clients' access to family planning in urban Uttar Pradesh, India: a mixed methods study

Public Deposited
Analytics

Downloadable Content

Download PDF
Request Version for Screen Reader
Creator
  • Calhoun, Lisa M
    • Affiliation: Carolina Population Center
  • Speizer, Ilene
    • Affiliation: Carolina Population Center
  • Rimal, Rajiv
    • Other Affiliation: George Washington University
  • Sripad, Pooja
    • Other Affiliation: Johns Hopkins University
  • Chatterjee, Nilesh
    • Other Affiliation: Johns Hopkins University
  • Achyut, Pranita
    • Other Affiliation: International Center for Research on Women
  • Nanda, Priya
    • Other Affiliation: International Center for Research on Women
Abstract
  • Background Medical barriers refer to unnecessary policies or procedures imposed by health care providers that are not necessarily medically advised; these restrictions impede clients’ access to family planning (FP). This mixed methods study investigates provider imposed barriers to provision of FP using recent quantitative and qualitative data from urban Uttar Pradesh, India. Methods Baseline quantitative data were collected in six cities in Uttar Pradesh, India from service delivery points (SDP), using facility audits, exit interviews, and provider surveys; for this study, the focus is on the provider surveys. More than 250 providers were surveyed in each city. Providers were asked about the FP methods they provide, and if they restrict clients’ access to each method based on age, parity, partner consent, or marital status. For the qualitative research, we conducted one-on-one interviews with 21 service providers in four of the six cities in Uttar Pradesh. Each interview lasted approximately 45 minutes. Results The quantitative findings show that providers restrict clients’ access to spacing and long-acting and permanent methods of FP based on age, parity, partner consent and marital status. Qualitative findings reinforce that providers, at times, make judgments about their clients’ education, FP needs and ability to understand FP options thereby imposing unnecessary barriers to FP methods. Conclusions Provider restrictions on FP methods are common in these urban Uttar Pradesh sites. This means that women who are young, unmarried, have few or no children, do not have the support of their partner, or are less educated may not be able to access or use FP or their preferred method. These findings highlight the need for in-service training for staff, with a focus on reviewing current guidelines and eligibility criteria for provision of methods.
Date of publication
DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Lisa M Calhoun et al.; licensee BioMed Central Ltd.
License
Journal title
  • BMC Health Services Research
Journal volume
  • 13
Journal issue
  • 1
Page start
  • 532
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1472-6963
Bibliographic citation
  • BMC Health Services Research. 2013 Dec 23;13(1):532
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • January 13, 2014

Relations

Parents:

This work has no parents.

Items

Thumbnail Title Date Uploaded Visibility Actions
file details 1472-6963-13-532.pdf 2019-05-06 Public Download
file details 1472-6963-13-532.xml 2019-05-06 Public Download