ABSTRACT
Contraceptive counselling for rightful decision-making in family planning methods selection is one important reproductive right of a woman. The study aimed to assess the quality of contraceptive counselling services in public health facilities of Zamfara state. The study identified the number of formally/certified FP-trained service providers, assessed the quality of contraceptive counselling, identified the number of clients offered, the pattern of contraceptive method mix in the last six months preceding the study, and client ̳s satisfaction with service provision. A concurrent mixed method study design (qualitative and quantitative) method was employed. Seven (7) public healthcare facilities out of the 22 available hospitals were selected for the study through a multi-stage sampling technique from which 48 clients were interviewed. The tools for data collection were an observation guide, and an interview checklist adopted from Kim (1995) used to elicit responses from the respondents via overt non-participant observations during counselling sessions, client exit interviews and clients’ satisfaction with the service provision. Service delivery registers of the selected facilities were scrutinized for the availability of contraceptive method mix in the last six months prior to the survey. The number of formally trained FP providers in the selected facilities was obtained from the state MCH coordinator and corroborated at the facilities by the respective head of the FP clinics. Data from Client Exit Interviews (CEI) was transcribed in Hausa and translated into English by a translation expert which was subsequently analysed manually using the thematic content methodology. The reports from the counselling session observations were coded and analyzed manually. The data on the contraceptive method mix was analyzed using an excel spreadsheet 2010 and presented in a table and simple percentages. Pearson correlation coefficient was used to test the relationship between variables at a p-value of 0.05. Findings revealed that most respondents are within the reproductive age 20-39 years with a range between 4-6 parity haven the highest % of 39.5. The majority had secondary education, and all were married (100%). The quality of client-provider interaction was poor, as evaluated by the researcher and reported by the respondents. Trained service providers were in short supply with 50%. Nearly 4,000 clients were offered various contraceptive method mix in which the injectable was the commonest method accounting for one-quarter of these clients, followed closely by the implant with 34.7%; despite poor client-provider interaction, clients were still satisfied with some aspect of counselling, such as greeting, provision of free contraceptive and information they received from their service providers. A correlation was seen between various subsets of client satisfaction and socio-demographic characteristics; occupation and parity were correlated with the counselling session (p=0.012) and (0.050), respectively. The findings suggest the need for increased awareness and enlightenment on FP counselling to women through mass media, mass employment by the government to address shortages and the need for FP providers to be specifically trained on contraceptive counselling techniques to improve the quality of FP counselling services in public health facilities in Zamfara state.
Keywords: Service, Quality, Contraceptive Counselling, Method Mix, Service Providers
REFERENCES
Achyut, P., Nanda, P., Khan, N., and Verma R. (2015).Quality of Care in Provision of Female Sterilization and IUD Services: An Assessment Study in Bihar. New Delhi, International Center for Research on Women. Retrieved from https://www.icrw.org/sites/default/files/images/QoC_FS_Brief.pdf
Aminu, U.K. Determinant of clients satisfaction with family planning services in government health facilities in Sokoto, Northern Nigeria. Sahel journal of health care. Doi.10.4103/1118-8561.152154.2015
Arrowsmith, M.E., Aicken, C.R.H., Saxena, S. and Majeed, A. (2012).Strategies for improving the acceptability and acceptance of the copper intrauterine device. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD008896. DOI: 10.1002/14651858.CD008896.pub2.
Askew, I., Mensch, B. and Adewuyi, A. (1994).―Indicators for Measuring the Quality of Family Planning Services in Nigeria.‖Studies in Family Planning, Vol. 25, No. (September–October), 268-283. Retrieved from www.jstor.org/doi/xml/10.2307/20454464
Assessment of Family Planning Use in Bauchi and Sokoto States, Nigeria, Health
Communication Capacity Collaborative, 2015. Retrieved from http://healthcommcapacity.org/wp-content/uploads/2015/08/HC3-FP- Assessment- in-Nigeria-Revised-24_Jul15. Pdf USAID, 2015.
Ayona, W. B. (2017). Assessment of client satisfaction on family planning services utilization in Wonji hospital Ethiopia. JclinDiagn 137. Doi. 10.4172/2376- 0311.1000137.2015
Assessment of Quality of Contraceptive Counselling Services in Public Health Facilities of Zamfara State