In developing countries, many service providers try to organize their work so that it meets their own desires for convenience, minimal effort, insulation from taxing situations, and maintenance of authority. Unfortunately, because of infrequent supervision and clients' inability to influence service delivery, these biases and prerogatives of providers can take precedence over a country's published guidelines for client-centered care. As a result, clients may encounter significant barriers to obtaining services, especially family planning services.
This presentation gives evidence on how providers curtailed access to family planning services in Malawi. The data is from a nationwide study conducted in 1995 on quality of care. The researcher trained Malawian women to pose as new family planning clients interested in obtaining oral contraceptives. These simulated clients visited only health centers and dispensaries where the author had already confirmed that at least one trained family planning provider was on duty. Of 102 simulated client visits, 66 were able to get the services they wanted, 26 were turned away "at the doorstep," and 10 were denied services after meeting with a family planning provider. The author describes the reasons given for denying services, gives insight into providers' rationales for denying services, and discusses the implications for clients' access.
Learning Objectives: At the end of the presentation, participants will be able to: 1. Identify at least five barriers to service delivery in Malawi 2. Understand the reasons for these barriers 3. Understand their implications for clients
Keywords: Family Planning, Access to Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.