Assessing and Improving Quality of Care/"Counseling and Informed Choice on RH/FP" provided by Private Practitioners in Nepal

Statement: Private practitioners in health service delivery have been increasing trend in Nepal. The services are delivered by private practitioners through Franchised service Outlets "Sangini" . This study aimed to assess the private practices on Counseling and Informed Choice focusing on RH/FP services to improve in quality service delivery.

Methodology: This is a descriptive study conducted in 1,765 "Sangini" outlets covering 51 districts. The unit of analysis was Sangini outlet and methods like interview, observation and simulation were used.

Major Findings:

• The majority of service providers were AHW/CMA who did 15 months academic training course.

• The privacy kept in service site and during service delivery was good.

• Only few outlets had either Sangini painting or Board. None of them had any BCC posters.

• Almost all service providers offered greeting politely and treated clients respectfully. Concerning as an overall process, only 15 percent of outlets performed very well in pre-procedure and 28.7 percent in post procedure counseling.

• Only 23.4 percent outlets performed very well on assessing clients before providing service.

• The practice of asking RH intentions was low and few of them explained that FP method selected (except condom) does not protect against STI/HIV. Similarly, few of them suggested clients for ANC examination if clients want for pregnancy.

Implications: Based on the outcome of the assessment, the need of training was identified. Quality monitoring system has been set. Developed tools and oriented staff. Now, the implementation of quality monitoring and training are undergoing in action.