Access, Quality Of Care and Medical Barriers In Family Planning Programs

TLDR

The article situates its framework within the supply environment of family planning services, distinguishing factors inside versus outside service delivery points. It aims to clarify overlapping definitions of access and quality in family planning programs and outline research priorities for scoring, measuring client perspectives, and validating these concepts. It defines access and quality terms, discusses related issues, and proposes methods for scoring, measuring client perspectives, and validating linkages. The article concludes that access requires more than geographic availability, that access and quality must be improved together, that quality promotion should combine humanitarian and demographic rationales, that expanding FP services demands attention to medical barriers and quality monitoring, and that a balanced approach is essential.

Abstract

This article offers a conceptual scheme that clarifies the confusion and overlap existing among the definitions of of and as these terms apply to family planning (FP) programs. After an introduction the article explains that these concepts are characteristics of the supply environment and apply to any type of service delivery point. The article also bases its framework on a distinction between what happens inside and outside of the service delivery point. The article then defines the terms and discusses related issues and concerns. The next sections explore the linkages among the terms and set forth the following research priorities: 1) developing methods of scoring various elements of quality 2) improving methods of measuring clients perspectives of access and quality 3) verifying the population-based effects of variations among the components of the concepts and 4) validating the presumed linkages among these concepts. Finally the article enumerates the policy implications of its attempt to clarify these concepts as follows: 1) access involves more than simply geographic availability of services points 2) access and quality must be enhanced concurrently 3) quality promotion should employ a humanitarian and a demographic rationale 4) expansion of FP services to include reproductive health services will require careful consideration of medical barriers as well as monitoring of levels of quality of care and 5) that it is important to have a balanced approach.