title: Comparison of family-planning service quality reported by adolescents and young adult women in Mexico.
abstract: OBJECTIVE
  Associations between age and patient-reported quality of family planning services were examined among young women in Mexico.
  
  
  METHODS
  A repeated cross-sectional analysis of survey data collected in 2006, 2009, and 2014 was performed. Data from women aged 15-29years who had not undergone sterilization and were currently using a modern contraceptive method were included. The primary outcome was high-quality care, defined as positive responses to all five quality items regarding contraceptive services included in the survey. Multivariable logistic regression and marginal probabilities were used to compare adolescents and women aged 20-29years. The responses of respondents using different contraceptive methods were compared.
  
  
  RESULTS
  Data were included from 15 835 individuals. The multivariable analysis demonstrated lower odds of reporting high-quality care among women aged 15-19years (odds ratio 0.73; 95% confidence interval 0.60-0.88) and 20-24years (odds ratio 0.85; 95% confidence interval 0.75-0.96) compared with women aged 25-29years. Adolescents using hormonal and long-acting reversible contraception had significantly lower odds of reporting high-quality care compared with women aged 25-29.
  
  
  CONCLUSIONS
  Adolescents in Mexico reported a lower quality of family planning services compared with young adult women. Continued research and policies are needed to improve the quality of contraceptive services.
authors.affiliation: Center for Health Systems Research, National Institute of Public Health Cuernavaca, Morelos, Mexico; Oregon Health and Science University, Portland, OR, USA. Electronic address: blair.darney@insp.mx.
authors.forename: Blair G
authors.initials: BG
authors.lastname: Darney
authors.affiliation: Center for Health Systems Research, National Institute of Public Health Cuernavaca, Morelos, Mexico.
authors.forename: Biani
authors.initials: B
authors.lastname: Saavedra-Avendano
authors.affiliation: Center for Health Systems Research, National Institute of Public Health Cuernavaca, Morelos, Mexico.
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Sosa-Rubi
authors.affiliation: Center for Health Systems Research, National Institute of Public Health Cuernavaca, Morelos, Mexico; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Lozano
authors.affiliation: Oregon Health and Science University, Portland, OR, USA.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003267:Contraception / Q000379:methods*; D003270:Contraceptive Agents / Q000009:adverse effects; D003273:Contraceptive Devices / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008800:Mexico; D015999:Multivariate Analysis; D016017:Odds Ratio; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents
keywords: Adolescent; Contraceptive services; Family planning; Interpersonal quality; Mexico; Quality; Technical quality