Differences in quality of family planning services between the public and private sectors

APHA Scientific Session and Event Listing

Mai Do, DrPH¹, Sohail Agha, PhD¹, and Eva Silvestre, MA². (1) International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, (504) 988 - 3655, mdo@tulane.edu, (2) Department of International Health and Development/SPHTM, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112

Most of studies on quality of care in family planning have been in the public sector. This study compares quality of contraceptive service delivery in the public and private (including non-government) sectors in some developing countries, and how it may vary by socio-economic status of clients. Data come from the Service Provision Assessments in Ghana (2002) and Kenya (1999). Indicators on quality are measured along the Bruce framework . Socio-economic status (SES) is constructed based on asset ownership. In Kenya, data showed that while the public sector is better than the private sector in readiness to provide quality services, the actual quality is better in the private sector. Clients at private facilities are of better SES compared to clients in the public sector. Evidence on differential quality of services by SES is mixed: for example, in the private sector, better-off clients are more likely than poor clients to feel that they had adequate privacy during their consultation but less likely to believe that their information would be kept confidential, whereas in the public sector the opposite is found. In Ghana, the private sector has better infrastructure and provides more contraceptive methods, but the quality of its service delivery is not as high as in the public sector. Clients in the private sector are less educated than those in the public sector. While evidence of differential quality of care is mixed in the private sector, in the public sector, several indicators of quality of service do increase with client's education.

Learning Objectives:

By the end of this presentation, participants will be able to

1) assess systematic evidence on quality of family planning services in the private and public sectors, and
2) discuss the implications for quality improvement interventions in the private sector.

Keywords: Family Planning, Quality of Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Quality as a Rights Issue

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA