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CONTEXT: Provision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo's modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to long-acting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo. METHODS: Data for this study were collected in 2016 as part of a larger research study conducted in Lomé, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake. RESULTS: Of the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48-2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61-2.51). CONCLUSION: This study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider-client information exchange is necessary to ensure women's FP needs are met.

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BACKGROUND: The quality of care is greatly compromised specially in resource limited settings that influence the uptake and continuation of use of family planning services. However, there is paucity of studies in Jimma Town public hospitals. Thus this study aimed to assess the quality of family planning services and associated factors in Jimma Town public hospitals, Southwest Ethiopia. METHODS: A facility-based cross-sectional study design using both qualitative and quantitative methods was employed from March 25 to April 25, 2018. A total of 278 female family planning users (15-49 years old) in Jimma Town public hospitals were included in the study.The sample was calculated using single population proportion formula and consecutive sampling methods was used. Descriptive statistics and multiple logistic regressions were used for analysisis. RESULTS: The mean waiting time of the client before getting service and mean consultation duration were23.5 and 12.5 minutes respectively participant who were unable to read and write were 64% less likely to be satisfied than those who were completed primary and secondary or preparatory schooling (AOR=0.363:CI:0.160,0.822), and clients who were waited for < 30 2minutes at waiting area were 2.7 times more likely to be satisfied than those who waited ≥ 30 minutes (AOR=2.769:CI:1.300,5.898). CONCLUSIONS: In this study, the satisfaction of clients in family planning service was low. Waiting time and received information on what to do in cases of problems and educational level of clients were significant predictors of client satisfaction.

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BACKGROUND: Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted to assess the quality of family planning services in primary health centers of Jimma Zone, Southwest Ethiopia. METHODS: A cross-sectional facility based study was conducted from March 1(st)-25(th), 2011 among family planning clients of government primary health care centers in southwest Ethiopia. Exit interview of 301 family planning clients identified through systematic random sampling technique was carried out using a pre-tested structured questionnaire. Availability of resources was checked using provider interview and inventory checklist. Moreover, a total of 150 consultation sessions were observed using checklist. Descriptive statistics and linear regression coefficients were generated to meet the objective of the study. RESULTS: There was a shortage of some medical equipment, trained staffs, and information education and communication materials (IEC) in all of the family planning clinics. The mean waiting time at the service delivery points and consultation duration were 16.4 and 10.5 minutes, respectively. The providers used at least one information education and communication material in 33.3% of the consultation sessions. The overall satisfaction score was 8.64. Clients' perception on adequacy of information during consultation (ß=0.24; ( 95%CI=0.02-0.16) ease of getting the clinic site, short waiting time (ß=0.17; 95%CI=0.15-029) and educational level (ß=0.09; 95%CI =0.09-0.29) were significantly associated with overall satisfaction. CONCLUSIONS: The findings of this study showed that there was lack of critical resources for the provision of quality family planning services in all of the primary health care centers included in the study. This has affected important aspects of service provision including the use of IEC materials during consultations. Hence, it is advisable that health managers of the health facilities and the district health office ensure improved availability of trained personnel, IEC materials and other supplies at the clinics.

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