Quality adjusted coverage of family planning services in low- and middle-income countries: Analysis of 33 countries using Demographic and Health Survey data

Monitoring service quality for family planning programmes in low- and middle-income countries (LMICs) has been challenging due to data availability. Self-reported service quality from Demographic and Health Surveys (DHS) can provide additional information on quality beyond simple service contact. Th...

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Bibliographic Details
Published in:	Journal of global health Vol. 14; p. 04125
Main Authors:	Hazel, Elizabeth A, Jiwani, Safia S, Maïga, Abdoulaye, Mady, Gouda Roland M, Wilson, Emily, Mwinnyaa, George, Amouzou, Agbessi
Format:	Journal Article
Language:	English
Published:	Scotland Edinburgh University Global Health Society 28-06-2024
Subjects:	Adolescent Adult Birth control Contraceptives Counseling Developing Countries Family planning Family Planning Services - statistics & numerical data Female Fertility Health facilities Health Services Accessibility Health Surveys Households Humans Intrauterine devices IUD Male Middle Aged Postpartum period Quality of Health Care Womens health Young Adult Armenia Asia Africa India
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Summary:	Monitoring service quality for family planning programmes in low- and middle-income countries (LMICs) has been challenging due to data availability. Self-reported service quality from Demographic and Health Surveys (DHS) can provide additional information on quality beyond simple service contact. The DHS collects need, use and counselling for contraceptives. We used this data from 33 LMICs to develop quality-adjusted demand for modern family planning satisfied indicator (DFPSq). We compared it with the crude indicator (demand for family planning satisfied (DFPS)) and performed an equity analysis. Median, interquartile ranges (IQR) and the absolute and relative gap by country were used to describe the findings. The median DFPS was 49% (IQR = 41-57%) and the median DPFSq was 19% (IQR = 14-27%). We found similar relative differences in the gap stratified by SES indicating quality was universally low. One exception is that adolescents had a higher relative gap (70%, IQR = 57-79%) compared to adults (54%, IQR = 46-68%), indicating lower quality access. Severe and pervasive quality gaps exist in family planning services across most LMICs. Our novel DFPSq indicator is one additional tool for monitoring access and quality of service that is critical to meet the family planning needs of women.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2047-2978 2047-2986 2047-2986
DOI:	10.7189/jogh.14.04125