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Improving quality of care by expanding contraceptive choice

Rebecka Inga Lundgren, MPH, Georgetown University Medical Center, Institute for Reproductive Health, 4301 Connecticut Ave., Suite 310, Washington, DC 20008 and Claudia Patricia Velasquez, MPH, Georgetown University School of Medicine, Institute for Reproductive Health, 4301 Connecticut Ave, NW, Suite 310, Washington, DC 20008, 202-687-1392, cv38@georgetown.edu.

Expanding method choice can improve quality of care, but introduction of new methods must focus on satisfying unmet need and improving overall quality. This paper presents results from Standard Days Method (SDM) introduction studies to assess how SDM integration influenced quality of care. Data was collected by 14 programs in six countries and includes prospective quarterly interviews with 1600 SDM users, service and supervision statistics and simulated client interviews. SDM integration improved quality of care by providing a new method to couples dissatisfied with available options. In 10 of the 14 studies, more than 40% of acceptors were new family planning users. In Benin, 85% of SDM acceptors had never used contraception. Service statistics reflect demand for the SDM, without displacing established methods; 6-10% of new users adopted the SDM, most had never used a method before. Effective use of client-dependent methods relies on good client provider interaction. SDM introduction included simple, low-cost training and supervision tools to facilitate clear, unbiased counseling; especially regarding couple and sexuality issues. Simulated client studies before and after introduction demonstrated improvements in informed choice and quality of care, regardless of the method ultimately chosen. The percentage of clients who felt free to choose their method increased from 38% to 75%, while provider bias decreased from 24% to 2%. Similarly, the percentage of counseling sessions which included discussion of STIs and condoms increased. Lessons learned regarding strategies to expand choice, while improving quality of care will be discussed.

Learning Objectives: At the end of the session participants will be able to

Keywords: Family Planning, Quality of Care

Related Web page: www.irh.org

Presenting author's disclosure statement:
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.

Improving Reproductive Health Program Quality and Outcomes

The 132nd Annual Meeting (November 6-10, 2004) of APHA