title: Quality of care in contraceptive services provided to young people in two Ugandan districts: a simulated client study.
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.
authors: Department of Nursing, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda. gnalwadda@gmail.con
authors: Gorrette
authors: G
authors: Nalwadda
authors: Nazarius M
authors: NM
authors: Tumwesigye
authors: Elisabeth
authors: E
authors: Faxelid
authors: Josaphat
authors: J
authors: Byamugisha
authors: Florence
authors: F
authors: Mirembe
mesh_terms: D000293:Adolescent; D003270:Contraceptive Agents / Q000592:standards*; D005163:Factor Analysis, Statistical; D005260:Female; D006282:Health Personnel / Q000592:standards; D006296:Health Services / Q000592:standards*; D006801:Humans; D008297:Male; D010361:Patients; D011787:Quality of Health Care / Q000592:standards*; D014454:Uganda; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents