Quality of family planning services at primary care facilities in an urban area of East Azerbaijan, Iran.
OBJECTIVE
To determine the quality of family planning (FP) services at primary care facilities in Tabriz, Iran, and to identify areas for improvement.


METHODS
Structured observations of 469 client-provider interactions and some clinical procedures at 34 facilities. Exit interviews with 416 of the observed clients.


RESULTS
The providers treated the clients respectfully in more than 80% of the consultations and discussed a return visit in 89%. Privacy was not assured in one-third of the cases. Over two-thirds of the clients were not encouraged to ask questions or raise concerns, and 54% were not satisfied with the amount of information given. The use of educational audio-visual and printed materials was very infrequent. Reported waiting time was less than 30 minutes in 89%. Most new clients received their preferred contraceptive method, but were informed about neither other available methods, nor common side effects and warning symptoms due to the chosen method. Provider performance in some clinical procedures, such as the implementation of hand hygiene, was insufficient.


CONCLUSIONS
All elements of the FP services need improvement. Special attention should be paid to interactive communication, information given to clients, privacy and confidentiality, as well as to infection prevention procedures. Multifaceted interventions seem necessary to improve the quality.
Mohammad-Alizadeh
S
S
Division of International Health (IHCAR), Department of Public Health Sciences, Child Health, Karolinska Institutet, Stockholm, Sweden. sakineh.mohammad.alizadeh@ki.se
Marions
L
L
Vahidi
R
R
Nikniaz
A
A
Johansson
A
A
Wahlström
R
R
D000328:Adult; D003267:Contraception / Q000523:psychology* / Q000706:statistics & numerical data; D005193:Family Planning Services / Q000592:standards*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D007492:Iran; D017533:Marital Status; D017060:Patient Satisfaction / Q000208:ethnology / Q000706:statistics & numerical data; D011320:Primary Health Care; D018907:Privacy; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D014505:Urban Population