2003 ANNUAL REPORT
Enhancing clients’ knowledge and use of contraceptives
through better quality of care
The idea that quality of care in family planning services makes a difference was put forth in the early 1990s by Judith Bruce, now Population Council program director of gender, family, and development, and Anrudh Jain, now the Council’s senior director of policy and regional programs. Quality is commonly measured by observing care and the nature of the interaction between providers and clients, and by interviewing clients about their experiences. In 2003, Council researchers showed that programs designed to improve quality of care can improve clients’ clinic experiences and increase their knowledge. Further, new research shows that if a woman receives high-quality care, she is more likely to use contraception than if she does not.
In Latin America, researchers from the Frontiers in Reproductive Health program found that a new counseling strategy led to significant improvements in clients’ interactions with clinic providers. In more than 300 family planning clinics in Peru, program staff trained counselors to ask clients about their reproductive goals, presented choices of contraceptive methods, and provided full information on the methods women chose. In Guatemala and Peru, where the strategy was replicated, clients’ knowledge of their chosen methods increased. John Townsend, director of Frontiers, explains, “Quality of care is both a right for clients and a good investment for program managers and policymakers concerned about clients’ reproductive health.”
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| In Senegal, if a woman receives high-quality care, she is more likely to continue using contraception than if she does not. |
In Asia, women who received good care during clinic visits were significantly more likely to use contraceptives for a longer time than those who did not. A research team in the Philippines, led by economic demographer Saumya RamaRao with investigators from Ateneo de Davao University, interviewed more than 1,700 new contraceptive users. After assessing the quality of care women received when they selected a method, researchers reinterviewed them 16 months later and found that 75 percent were still using contraception. Use of a modern method was greatest at the highest level of care.
In Senegal, a study of more than 1,000 new family planning users showed that these findings are replicable. “Clients who received good care were 1.3 times more likely to continue using contraceptives more than a year later than those who did not,” notes RamaRao, who led both studies. “A well-rounded information exchange between the client and the provider that includes clear explanations of all options and risks goes a long way.”
| Saumya RamaRao is a program associate in the International Programs Division. |  |
The USAID-funded Frontiers in Reproductive Health program applies systematic research techniques to improve delivery of family planning and reproductive health services and influence related policies. Frontiers is implemented by the Population Council with Family Health International and Tulane University.
