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APHA Scientific Session and Event Listing

Recorded presentation

Marya Plotkin, MPH, Nabeel Akram, MBBS, MPH, and Rebecca Dineen, MS. Family Planning and Reproductive Health Center of Excellence, JHPIEGO Corporation, 1615 Thames Street, Baltimore, MD 21231, 410.537.1809, mplotkin@jhpiego.net

Although Pakistan has increased FP usage, unmet need for contraception is still 33%. (Pakistan Reproductive Health and Family Planning Survey, 2000 - 01.) Studies show that between 39% - 44% of women seeking FP in Pakistan use the private sector. (National Consultation on MCH and FP in Pakistan, 2003.) Interviews were conducted with 271 private sector FP providers in three provinces of Pakistan to understand their practice of quality services. Results showed that quality of care for FP is neither regulated nor addressed in the private sector. Interviewees could not identify any activity taken to monitor the quality of their services, and only 16% indicated having manuals or policies on site. In many clinics infection prevention standards were poor: as few as 45% of midwives had gloves, 39% of all providers had no chlorine solution, and 51% had inadequate sharps disposal procedures. Interviewees associated “quality of services” with the contraceptive product, emphasizing those with few side effects, longer period of contraception, and attractive packaging. Providers expressed desire to improve quality of care including: preventing infections through a hygienic environment, improving counseling, ensuring privacy in clinics, and increasing availability of FP methods. With the widespread use of private sector FP services and the lack of regulation or support for quality of care, we conclude that programs to increase contraceptive prevalence in Pakistan must include a quality component.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the use of private sector FP services by Pakistani women.
• Characterize quality practices in private sector FP services.
• Recognize the public health importance of improving quality of care among private sector FP providers in Pakistan.

Keywords: Family Planning, Quality Assurance

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation