QUALITY OF CARE 

In the past decade, family planning services around the world have undergone a transformation. At one time, programs were typically bureaucratic and target-driven. Many now strive to address clients’ self-defined reproductive needs by providing them with relevant and accurate information and services of good quality. High-quality care is the cornerstone of client-oriented services. The theoretical basis of quality of care as a dimension of family planning services was developed by the Population Council's Judith Bruce in 1990 with the publication of "Fundamental elements of the quality of care: A simple framework." The framework she described defines six elements of quality of care:

• method choice;

• provision of information to clients;

• technical competence of providers;

• interpersonal relations between clients and providers;

• mechanisms for follow-up and continuity; and

• an appropriate array of services.

The framework has been useful in focusing attention on quality, in determining what factors hinder or advance the provision of high-quality care, and in helping family planning program managers and providers make changes to improve the quality of services.

Since the publication of this framework, Population Council researchers have developed, tested, and refined methodologies to measure quality; designed interventions to address gaps in quality; and broadened the body of knowledge available about the process of improving quality of care and its effects. It is well accepted that there must be a distinction between characteristics of services (e.g., availability of trained staff, equipment, number and types of contraceptives available) and the care actually provided. Council research has investigated many interventions to improve both of these components, including making large infrastructural improvements, upgrading buildings and equipment, training health care providers to improve their interactions with clients, and educating clients to seek better care.

Programs designed to improve quality of care can improve clients’ clinic experiences and increase their knowledge. Further, improving quality of care can result in more clients meeting their reproductive goals.

Council staff members conduct research on the following topics:

• Expanding Contraceptive Choice

• General Quality of Care

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