title: Evaluation of service quality in family planning clinics in Lusaka, Zambia.
abstract: OBJECTIVE
  To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach.
  
  
  METHODS
  We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up.
  
  
  RESULTS
  Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%).
  
  
  CONCLUSIONS
  This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability.
  
  
  CONCLUSIONS
  Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus Box 7577, Chapel Hill, North Carolina, 27599-7577; Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia. Electronic address: nancylhancock@gmail.com.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Hancock
authors.affiliation: Department of Obstetrics and Gynecology, University Teaching Hospital, PO Box 50110, Lusaka, Zambia.
authors.forename: Bellington
authors.initials: B
authors.lastname: Vwalika
authors.affiliation: Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia.
authors.forename: Elizabeth Siyama
authors.initials: ES
authors.lastname: Sitali
authors.affiliation: Lusaka District Community Health Office, Ministry of Community Development, Mother and Child Health, PO Box 50827, Lusaka, Zambia.
authors.forename: Clara
authors.initials: C
authors.lastname: Mbwili-Muleya
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus Box 7577, Chapel Hill, North Carolina, 27599-7577; Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Chi
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus Box 7577, Chapel Hill, North Carolina, 27599-7577.
authors.forename: Gretchen S
authors.initials: GS
authors.lastname: Stuart
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000592:standards*; D005260:Female; D006801:Humans; D011785:Quality Assurance, Health Care; D055815:Young Adult; D015024:Zambia
keywords: Africa; Contraception; Family planning; Quality