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Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study

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  • Gorrette Nalwadda
  • Nazarius M Tumwesigye
  • Elisabeth Faxelid
  • Josaphat Byamugisha
  • Florence Mirembe

Abstract

Background: Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods: Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results: Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions: The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed.

Suggested Citation

  • Gorrette Nalwadda & Nazarius M Tumwesigye & Elisabeth Faxelid & Josaphat Byamugisha & Florence Mirembe, 2011. "Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-8, November.
    • Handle: RePEc:plo:pone00:0027908
    DOI: 10.1371/journal.pone.0027908
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    References listed on IDEAS

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    1. Sima Berendes & Peter Heywood & Sandy Oliver & Paul Garner, 2011. "Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies," PLOS Medicine, Public Library of Science, vol. 8(4), pages 1-10, April.
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    1. Simon P S Kibira & Christine Muhumuza & Justine N Bukenya & Lynn M Atuyambe, 2015. "“I Spent a Full Month Bleeding, I Thought I Was Going to Die…” A Qualitative Study of Experiences of Women Using Modern Contraception in Wakiso District, Uganda," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-13, November.
    2. Andrew G. Corley & Andrea Sprockett & Dominic Montagu & Nirali M. Chakraborty, 2022. "Exploring and Monitoring Privacy, Confidentiality, and Provider Bias in Sexual and Reproductive Health Service Provision to Young People: A Narrative Review," IJERPH, MDPI, vol. 19(11), pages 1-22, May.
    3. Phillip Koni & Nathaniel Chishinga & Lameck Nyirenda & Prisca Kasonde & Richard Nsakanya & Michael Welsh, 2015. "Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-13, June.
    4. Dickens S Omondi Aduda & Collins Ouma & Rosebella Onyango & Mathews Onyango & Jane Bertrand, 2015. "Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-17, February.

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