Provider perspectives on barriers to family planning quality in Uganda: a qualitative study
Authors: Mugisha, John Frank1; Reynolds, Heidi2
Source: Journal of Family Planning and Reproductive Health Care, Volume 34, Number 1, January 2008 , pp. 37-41(5)
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Abstract:
Background and methodology: Provider perspectives on the quality of family planning services have been overlooked in quality of care research and interventions. This qualitative study was carried out in four districts in Uganda, a country where lack of access to quality family planning services remains a challenge. Using four focus group discussions, 16 provider in-depth interviews and nine manager in-depth interviews, this study documented providers' perceptions of quality of care and of barriers to quality services at the organisational and societal levels. To guide study development, analysis and interpretation, the authors relied on an ecological framework where providers' abilities are shaped by the larger organisational and societal environments in which providers live and work. Results: Providers felt that organisational factors, such as supply availability, workload and their own knowledge and skills, affected their abilities to offer quality care. At the same time, providers were challenged by societal factors such as male partner participation, financial constraints, misconceptions and leadership support. While making changes to the elements of quality care that clients experience is important, it is not sufficient in view of the organisational and social barriers. Discussion and conclusions: Across the different levels of the ecological framework, providers face barriers to providing quality family planning services that are synergistic. Solutions to improve quality of care must address also limitations at the organisational and societal levels since efforts to overcome a particular constraint are less likely to be successful if this interdependence is not taken into account.Keywords: FAMILY PLANNING; HEALTH CARE PROVIDER; QUALITY; UGANDA
Document Type: Research article
DOI: 10.1783/147118908783332230
Affiliations: 1: Research Fellow, Regional Centre for Quality of Health Care, Makerere University Institute of Public Health, Kampala, Uganda;, Email: fmugisha@rcqhc.org 2: Health Services Research Scientist, Family Health International, Research Triangle Park, NC, USA
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