The quality of care in family planning: a case study of Chogoria, Eastern Kenya
Population studies
9
Issue: 1
(04 - 1994)
This paper compares the quality of family planning
services in the catchment areas of Chogoria and
Maua hospitals, both in the Meru district of Kenya.
The quality issues compared are personnel, types
of methods, information, recruiting and
counselling of clients, knowledge and source of
modern contraceptives, desired family size, use of
contraceptives, and satisfaction of providers and
clients. A comparative approach is adopted to
study the aspects of family planning that have
made Chogoria relatively more successful than
Maua and the rest of Kenya. The data used in this
analysis is qualitative and was collected through
personal observation, interviews, and group
discussions with health care providers. The results
show that while the family planning programmes
of Chogoria and Maua are comparable in many
respects, there are also important differences.
For example, Chogoria family planning personnel
were more knowledgeable about contraceptives
and were more satisfied with the training
provided by Chogoria hospital than were their
counterparts in Maua. The relationship between
the senior and the junior staff was more cordial in
Chogoria. The content of the information about
contraceptives provided to women attending
clinics was similar in both hospitals. But the
teachers in Chogoria were more knowledgeable
and confident than those in Maua. In Chogoria,
the decision to use family planning is jointly taken
by the husband and the wife, and if a client fails to
turn up for an appointment a follow-up is
scheduled. In Maua, the decision to use family
planning is taken unilaterally by the wife and
defaulters are not followed up. The study showed
that 78 percent and 33 percent of the participants
were using modern family planning methods in
Chogoria and Maua respectively. Three
conclusions are drawn from the study. First, that
the satisfaction of family planning providers and
their clients contributes positively towards more
knowledge and use of modern contraceptives.
Second, that women feel more secure and
comfortable with the methods they use if their husbands are involved in deciding whether or not
to adopt them. Finally, follow-up services for
those who fail to attend appointments helps to
strengthen rapport between providers and clients
and provides an opportunity to learn of the
circumstances that lead to discontinuing the use
of contraceptives.
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