The Council is leading efforts to measure quality of care and needed improvements for scaling up family planning programs worldwide.
There is a renewed global commitment to achieving universal access to high-quality family planning services. The Bruce quality of care (QoC) framework, developed more than two decades ago, has become a cornerstone in helping to ensure quality in international family planning (FP) programming today. However, in the last 25 years, the global community has seen significant changes in health policies and family planning programming. These changes highlight the need to update and align methodologies for measuring and monitoring quality of care and services in order prevent poor quality family planning services which may act as a barrier to greater contraceptive continuation and use. This will ultimately ensure that every woman with a desire to delay or limit future pregnancies has access to contraceptive information and services of her choice.
The Population Council is leading efforts to measure quality of care and improvements necessary for scaling up family planning programs. With support from the David and Lucile Packard Foundation, Council researchers are:
- Convening experts to share insights, identify the challenges in measuring and monitoring quality of care, and reinvigorate efforts to address these issues.
- Reviewing literature and sharing insights on various conceptual frameworks of QoC and human rights and methodologies and tools used in the past to measure and monitor QoC with the global community.
- Analyzing Demographic and Health Survey (DHS) data to understand what can be learned from the ongoing, repeated cross-sectional surveys.
Initial findings of this project suggest that:
- While a rights-based approach to family planning includes quality, the reverse is not true. Moreover, there is no need to expand the Bruce QoC framework to incorporate dimensions such as availability, accessibility, acceptability, efficiency, effectiveness, sustainability, and equity of services (or even gender equity). Rather, services need to be analyzed using each of these dimensions to identify both the gaps within a country and the steps required to remedy the situation.
- Achieving the ambitious FP2020 goal of enabling 120 million more women and girls to use contraceptives by 2020 requires not only helping never users to initiate contraception, but also increased efforts to reduce high contraceptive discontinuation and the contribution of past users to unmet need and unintended fertility.
- Concerted efforts are required to improve QoC and the content of information between providers and clients. There is also a need to explore other ways to inform clients about contraceptives, their use, and options for discontinuation.
Evidence generated under this project will provide the international community a better understanding of the quality of current family planning programs and help ensure that high-quality services are available and accessible to all women around the world.