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Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey

BACKGROUND: In Mozambique, both the government and partners have undertaken efforts over the last decade to improve FP (family planning) services, especially through training health care providers and promoting the uptake of LARCs (Long Acting Reversible Contraceptives). Despite this, uptake of FP m...

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Autores principales: Galle, Anna, Vermandere, Heleen, Griffin, Sally, de Melo, Málica, Machaieie, Lino, Van Braeckel, Dirk, Degomme, Olivier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291923/
https://www.ncbi.nlm.nih.gov/pubmed/30541528
http://dx.doi.org/10.1186/s12905-018-0692-z
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author Galle, Anna
Vermandere, Heleen
Griffin, Sally
de Melo, Málica
Machaieie, Lino
Van Braeckel, Dirk
Degomme, Olivier
author_facet Galle, Anna
Vermandere, Heleen
Griffin, Sally
de Melo, Málica
Machaieie, Lino
Van Braeckel, Dirk
Degomme, Olivier
author_sort Galle, Anna
collection PubMed
description BACKGROUND: In Mozambique, both the government and partners have undertaken efforts over the last decade to improve FP (family planning) services, especially through training health care providers and promoting the uptake of LARCs (Long Acting Reversible Contraceptives). Despite this, uptake of FP methods has not increased significantly. This study aims to examine women’s knowledge on LARCs, including their main sources of information, and the quality of care of FP services in rural areas. METHODS: We conducted a repeated cross-sectional study, interviewing 417 women leaving FP consultations in 15 health facilities in Maputo Province, Mozambique. The main quality outputs measured were: 1)discussed, preferred and received contraceptive methods, 2)information received on usage and side-effects, 3)client-provider interaction, 4)being informed about the need for a follow-up visit 5)health examinations conducted and travel time to the facility. In addition, knowledge on LARCs was measured among the clients as well as sources of information regarding FP methods. Taking into account the design effect of the study, Chi-square statistics were used to detect differences between groups and linear regression analyses to identify associations between sources of information and higher knowledge. RESULTS: We found that IUDs (intrauterine devices) and implants were discussed in 23 and 33% of the consultations respectively, but only administered in a very few cases(< 1%). Half of the women were counselled on side-effects of contraceptives; this did not differ between first time clients and follow-up clients. Almost all women(98%) were satisfied with the received service and 83% of the women found the waiting time acceptable. Health examinations were performed on 18% of the women. Overall, women’s knowledge about LARCs was poor and misconceptions are still common. Women who had received FP information through outreach activities had better knowledge than those counselled at a facility. CONCLUSIONS: Our study highlights that only a minority of the women received information regarding LARCs during the consultation and that usage is almost non-existent. Counseling about all types of contraceptives during the consultation is sub-optimal, resulting in poorly informed clients. Multifaceted long-term interventions, focusing on both users and providers, are needed to improve uptake of contraceptives (including LARCs) in rural areas. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12905-018-0692-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-62919232018-12-17 Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey Galle, Anna Vermandere, Heleen Griffin, Sally de Melo, Málica Machaieie, Lino Van Braeckel, Dirk Degomme, Olivier BMC Womens Health Research Article BACKGROUND: In Mozambique, both the government and partners have undertaken efforts over the last decade to improve FP (family planning) services, especially through training health care providers and promoting the uptake of LARCs (Long Acting Reversible Contraceptives). Despite this, uptake of FP methods has not increased significantly. This study aims to examine women’s knowledge on LARCs, including their main sources of information, and the quality of care of FP services in rural areas. METHODS: We conducted a repeated cross-sectional study, interviewing 417 women leaving FP consultations in 15 health facilities in Maputo Province, Mozambique. The main quality outputs measured were: 1)discussed, preferred and received contraceptive methods, 2)information received on usage and side-effects, 3)client-provider interaction, 4)being informed about the need for a follow-up visit 5)health examinations conducted and travel time to the facility. In addition, knowledge on LARCs was measured among the clients as well as sources of information regarding FP methods. Taking into account the design effect of the study, Chi-square statistics were used to detect differences between groups and linear regression analyses to identify associations between sources of information and higher knowledge. RESULTS: We found that IUDs (intrauterine devices) and implants were discussed in 23 and 33% of the consultations respectively, but only administered in a very few cases(< 1%). Half of the women were counselled on side-effects of contraceptives; this did not differ between first time clients and follow-up clients. Almost all women(98%) were satisfied with the received service and 83% of the women found the waiting time acceptable. Health examinations were performed on 18% of the women. Overall, women’s knowledge about LARCs was poor and misconceptions are still common. Women who had received FP information through outreach activities had better knowledge than those counselled at a facility. CONCLUSIONS: Our study highlights that only a minority of the women received information regarding LARCs during the consultation and that usage is almost non-existent. Counseling about all types of contraceptives during the consultation is sub-optimal, resulting in poorly informed clients. Multifaceted long-term interventions, focusing on both users and providers, are needed to improve uptake of contraceptives (including LARCs) in rural areas. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12905-018-0692-z) contains supplementary material, which is available to authorized users. BioMed Central 2018-12-12 /pmc/articles/PMC6291923/ /pubmed/30541528 http://dx.doi.org/10.1186/s12905-018-0692-z Text en © The Author(s). 2018 Open AccessThis 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
Galle, Anna
Vermandere, Heleen
Griffin, Sally
de Melo, Málica
Machaieie, Lino
Van Braeckel, Dirk
Degomme, Olivier
Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
title Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
title_full Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
title_fullStr Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
title_full_unstemmed Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
title_short Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
title_sort quality of care in family planning services in rural mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291923/
https://www.ncbi.nlm.nih.gov/pubmed/30541528
http://dx.doi.org/10.1186/s12905-018-0692-z
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