tailieunhanh - Overview of Quality of Care in Reproductive Health: Definitions and Measurements of Quality

Since 2005, the international development perspectives have broadened, with new funding sources, partnerships and configurations of stakeholders. Global public-health initiatives such as the Global Alliance for Vaccines and Immunisation (GAVI) and the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) have matured their operations and increasingly become significant sources of revenue for national health budgets in many low-income countries. Additional, new resources are being accessed from the private sector and corporate philanthropy, broadening the partnerships in health interventions and challenging public-sector models of governance. The Organisation for Economic Co-operation and Development (OECD) had secured agreement on the Paris Declaration. | New Perspectives on Quality of Care No. 1 Population Council and Population R efe r ence Bureau Overview of Quality of Care in Reproductive Health Definitions and Measurements of Quality Liz C. Creel Justine V. Sass and Nancy V. Yinger Quality of care a client-centered approach to providing high-quality health care as a basic human right has emerged as a critical element of family planning and reproductive health programs. It has been promoted by local stakeholders such as women s health and primary health care organizations and affirmed at international conferences such as the 1994 International Conference on Population and Development. High-quality services ensure that clients receive the care that they deserve. Furthermore providing better services at reasonable prices attracts more clients increases the use of family planning methods and reduces the number of unintended pregnancies. Several impact studies have shown that improving the quality of reproductive health services increases contraceptive use. Studies in Bangladesh Senegal and Tanzania showed that women s contraceptive use was higher in areas where clients felt that they were receiving good care than it was in areas with lower-quality health facilities Koenig et al. 1997 Mroz et al. 1999 Speizer and Bollen 2000 . Providing high-quality care also makes sense for service providers since improving basic standards of care attracts more clients reducing per capita costs of services and ensuring sustainability. For example the Bangladesh Women s Health Coalition attracts clients by providing a mix of services so that clients can use a visit for more than one purpose and by having well-trained paramedical personnel rather than physicians perform pelvic exams IUD insertions and menstrual regulation services. The high volume of clients has enabled the program to distribute its fixed costs over a larger number of clients allowing the coalition to serve more people at a lower cost Kay et al. 1991 as cited in Kols