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Assessing the Quality of Care in Family Planning, Antenatal, and Sick Child Services at Health Facilities in Kenya, Namibia, and Senegal

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Assessing the Quality of Care in Family Planning, Antenatal, and Sick Child Services at Health Facilities in Kenya, Namibia, and Senegal ASSESSING THE QUALITY OF CARE IN FaMILY PLANNING, ANTENATAL, AND SICK CHILD SERVICES AT HEALTH FACILITIES IN KENYA, NAMIBIA, AND SENEGAL DHS ANALYTICAL STUDIES 44 SEPTEMBER 2014 This publication was produced for review by the United States Agency for International Development. It was prepared by Wenjuan Wang, Mai Do, John Hembling, and Paul Ametepi. DHS Analytical Studies No. 44 Assessing the Quality of Care in Family Planning, Antenatal, and Sick Child Services at Health Facilities in Kenya, Namibia, and Senegal Wenjuan Wang Mai Do John Hembling Paul Ametepi ICF International Rockville, Maryland, USA September 2014 Corresponding author: Wenjuan Wang, International Health and Development, ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; telephone: +1 301-572-0398: fax: +1 301-572-0950; email: [email protected] Acknowledgment: The authors would like to thank Sohail Agha for reviewing this report and providing invaluable comments. Editor: Bryant Robey Document Production: Natalie La Roche This study was carried out with support provided by the United States Agency for International Development (USAID) through The DHS Program (#AID-OAA-C-13-00095). The views expressed are those of the author and do not necessarily reflect the views of USAID or the United States Government. The DHS Program assists countries worldwide in the collection and use of data to monitor and evaluate population, health, and nutrition programs. For additional information about the DHS Program contact: DHS Program, ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; phone: 301-407-6500, fax: 301-407-6501, email: [email protected], Internet: www.dhsprogram.com. Recommended citation: Wang, Wenjuan, Mai Do, John Hembling, Paul Ametepi. 2014. Assessing the Quality of Care in Family Planning, Antenatal, and Sick Child Services at Health Facilities in Kenya, Namibia, and Senegal. DHS Analytical Studies No. 44 Rockville, Maryland, USA: ICF International. 3 Contents Tables ......................................................................................................................................................... v Figures ....................................................................................................................................................... vii Preface ........................................................................................................................................................ ix Abstract ....................................................................................................................................................... xi Executive Summary ................................................................................................................................. xiii 1. Introduction .................................................................................................................................... 1 2. Data and Methods .......................................................................................................................... 3 2.1 Data Used in the Analysis ........................................................................................................ 3 2.1.1 Data from facility inventory ............................................................................................ 3 2.1.2 Data from observations and exit interviews ................................................................... 4 2.1.3 Data from providers ........................................................................................................ 4 2.2 Definitions of Variables ............................................................................................................ 4 2.2.1 Structure and process variables ...................................................................................... 4 2.2.2 Client satisfaction ........................................................................................................... 5 2.2.3 Other covariates ............................................................................................................. 5 2.3 Statistical Methods ................................................................................................................... 5 3. Results ...................................................................................................................................................... 7 3.1 Family Planning ....................................................................................................................... 7 3.1.1 Distribution of the sample ............................................................................................... 7 3.1.2 Description of family planning service quality attributes ................................................ 9 3.1.3 Factors associated with family planning client’s satisfaction ....................................... 19 3.2 Antenatal Care ....................................................................................................................... 21 3.2.1 Distribution of the sample ............................................................................................. 21 3.2.2 Description of ANC service quality attributes ............................................................... 23 3.2.3 Factors associated with ANC client’s satisfaction ........................................................ 30 3.3 Sick Child Care ...................................................................................................................... 33 3.3.1 Distribution of the sample ............................................................................................. 33 3.3.2 Description of sick child service quality attributes ........................................................ 35 3.2.4 Factors associated with sick child client’s satisfaction ................................................. 46 4. Discussion and Conclusion ................................................................................................................... 49 References .................................................................................................................................................. 53 Appendix A ................................................................................................................................................ 55 Appendix B ................................................................................................................................................ 57 iii Appendix C ................................................................................................................................................ 59 Appendix D ................................................................................................................................................ 61 Appendix E ................................................................................................................................................ 63 Appendix F ................................................................................................................................................ 65 Appendix G ................................................................................................................................................ 67 Appendix H ................................................................................................................................................ 69 iv Tables Table 1. Sample distribution of facilities, provider interviews, and observations/client exit interviews in the family planning analysis ................................................................................ 8 Table 2. Attributes of quality of care in family planning services among all facilities and providers of family planning services and family planning clients ......................................... 10 Table 3. Factors associated with client satisfaction score related to family planning services ............. 20 Table 4. Sample distribution of facilities, provider interviews, and observations/client exit interviews in the ANC analysis ............................................................................................... 22 Table 5. Attributes of quality of care in ANC services among all facilities and providers of ANC services, and ANC clients ....................................................................................................... 24 Table 6. Factors associated with client satisfaction score related to ANC services .............................. 32 Table 7. Sample distribution of facilities, provider interviews, and observations/client exit interviews in the sick child analysis ........................................................................................ 34 Table 8. Attributes of quality of care in sick child services among all facilities and providers of sick child services and sick child clients ......................................................................................... 36 Table 9. Factors associated with client satisfaction score related to sick child services ....................... 47 v vi Figures Figure 1. Kenya: Percentage of family planning facilities with high structure, process and satisfaction score by type of facility ......................................................................................... 11 Figure 2. Kenya: Percentage of family planning facilities with high structure, process and
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