Association between Facility-Level Quality of Family Planning Services and Contraceptive Behavior in Urban Uttar Pradesh, India

Over the last 15 years, family planning (FP) programs have focused on increasing access to high quality FP services, yet unmet need remains high in developing country settings. This presentation shares the results of an investigation into the association between quality of family planning (FP) service provision and current use of contraception among women in select cities in Uttar Pradesh, India. In 2010, cross-sectional data were collected from 3,000 currently married women in each of six cities. Audits of preferred facilities were conducted on 100+ facilities in each city. This analysis links women in the individual-level survey to an accessible high volume private facility. High quality services were defined by whether FP clients at the facility were offered information on side effects, told when to return for follow-up, and offered other services in addition to FP. In a preliminary assessment of the data, the authors estimated prevalence odds ratios (POR) using crude and stratified tabular analysis and unconditional logistic regression. Crude estimates indicated that the odds of women using contraception when the accessible high volume facility was of higher quality were 1.16 (95% CI 0.99, 1.36) times the odds of using contraception compared to those women with access to lower quality services. Stratified tabular analysis suggested that the protective effect of high quality services varied by women's age and education level. This suggests that promoting quality FP services is key to ensuring that women are able to effectively attain their desired family size.