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Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya

BACKGROUND: Nearly 40 % of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. METHODS: We conducted six focus groups discussions and 51 in-depth interviews with p...

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Autores principales: Keesara, Sirina R., Juma, Pamela A., Harper, Cynthia C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4545906/
https://www.ncbi.nlm.nih.gov/pubmed/26290181
http://dx.doi.org/10.1186/s12913-015-0997-7
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author Keesara, Sirina R.
Juma, Pamela A.
Harper, Cynthia C.
author_facet Keesara, Sirina R.
Juma, Pamela A.
Harper, Cynthia C.
author_sort Keesara, Sirina R.
collection PubMed
description BACKGROUND: Nearly 40 % of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. METHODS: We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. RESULTS: When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. CONCLUSION: Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.
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spelling pubmed-45459062015-08-23 Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya Keesara, Sirina R. Juma, Pamela A. Harper, Cynthia C. BMC Health Serv Res Research Article BACKGROUND: Nearly 40 % of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. METHODS: We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. RESULTS: When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. CONCLUSION: Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care. BioMed Central 2015-08-20 /pmc/articles/PMC4545906/ /pubmed/26290181 http://dx.doi.org/10.1186/s12913-015-0997-7 Text en © Keesara et al. 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Keesara, Sirina R.
Juma, Pamela A.
Harper, Cynthia C.
Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya
title Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya
title_full Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya
title_fullStr Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya
title_full_unstemmed Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya
title_short Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya
title_sort why do women choose private over public facilities for family planning services? a qualitative study of post-partum women in an informal urban settlement in kenya
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4545906/
https://www.ncbi.nlm.nih.gov/pubmed/26290181
http://dx.doi.org/10.1186/s12913-015-0997-7
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