Measuring the Quality of Family Planning

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By: Sarah Hodin, MPH, CD(DONA), LCCE, National Senior Manager of Maternal Newborn Health Programs, Steward Health Care

In October 2015, researchers, programmers and policymakers gathered in Bellagio, Italy to discuss strategies for improving, standardizing and simplifying the measurement of quality in family planning. The resulting papers, along with commentaries from Dominic Montagu and Kim Longfield, were published by Metrics for Management in late 2016.

Issues surrounding family planning have gained momentum in recent years, exemplified by the work of Family Planning 2020 and the inclusion of the Sustainable Development Goal 3 target to “ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs” by 2030. Forty years of research has taught the global family planning community that quality is equally important as (if not more important than) affordability of services for increasing utilization of contraceptives. However, accurately measuring quality can be challenging. While numerous strategies, many of which are described in this series of papers, have been used to measure the quality of family planning services, a lack of standardization limits researchers’ capacity to compare programs in diverse global settings.

The stakeholders who participated in the Bellagio meeting agreed that an effective measure of family planning quality should be:

– Standardized
– Simple
– Credible
– Actionable
– Easy and inexpensive to use
– Able to facilitate comparison against national standards
– Valued by providers

The papers in this series provide an opportunity to review and learn from what has already been done and work towards consensus on a more effective measurement strategy moving forward.

The importance of quality to family planning

  • The evolution of strategies and measurement methods to assess the quality of family planning services
  • Steps toward improving quality of care in private franchises

Experiences with measuring quality to date

  • An innovative public-private approach for benchmarking quality of healthcare: Implementing SafeCare in 556 healthcare facilities in Kenya, 2011-2016
  • Overcoming challenges in quality assurance for social franchises for healthcare: Experiences from case studies in Kenya, Uganda and Pakistan, 2008-2015
  • Constructing indicators for measurement and improvement of the quality of family planning programs: An example using data on choice from the Philippines, 1997-1998
  • Social franchising for improving the clinical quality of family planning services and increasing client volumes at privately owned clinics: Evidence from the Suraj social franchise network, Pakistan, 2013-2014
  • Quality in social franchises: Challenges of improving interpersonal relations, with qualitative data from Asia and Africa, 2015
  • Examining progress and equity in information received by women using a modern method in 25 developing countries

Key considerations for making progress in quality measurement

  • Family planning quality assessment tools used in low- and middle-income countries: Review for application in clinic-based services
  • Options for measuring the quality of family planning programs: The experience of social franchisor Population Services International
  • The quality of healthcare: Measurement of improvement or measurement for improvement?
  • Benchmarking to assess quality of family planning services: Construction and use of indices for family planning readiness in Kenya with data from 2010 and 2014

Access the full series of papers from the Bellagio meeting.

Learn about the connection between family planning and maternal health.

Check out other posts from the MHTF’s Quality of Maternal Health Care blog series.