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Background: Good quality of care in family planning counseling services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning counseling services could enhance family planning services utilization.
Objective: This study was conducted to assess the compliance rate of the family planning consoling with the national standards in public health center in Ahvaz, Iran.
Methods: A descriptive facility based study was conducted among family planning counseling client of government primary health care centers in Ahvaz, Iran. Structured observations of 115 client–provider interactions. Exit interviews with 115 of the observed clients. Descriptive statistics were generated to meet the objective of the study.
family planning; counseling; national standard; contraceptive
Family planning programs were revised at 1989 in Iran of whose most important goals were to control the birth and decrease the population rise (1). This plan was one of the most successful ones of the world. Nowadays, the family planning has separated from the concept of population control and is introduced as a fundamental component in pregnancy rights, competency and improvement in the women’s situation in the society (2). Health servicing providers’ familiarity with the procedures based on the rights in the realm of the health , reproductive and sexual, ready the ways for the access to the client – oriented services with the utmost standard(3).
On one hand, services providing the clients with the necessary information on sexuality and reproductive by the conscious choice and satisfaction respecting the dignity, privacy and the secrecy of the information without any discrimination and sexual orientation and along with preserving the continuation of care will lead to enabling the services customers. Annual 80000 abortions have been reported in Iran many of whom lead to death or disability due to non-medical abasements (4). This is largely related to the improper behavior of family planning (3).
The goals of Iran’s current national FP program are to decrease unwanted and high risk pregnancies and one of its strategies is to improve the quality of the reproductive health services (5).
The results from studies in different countries suggest that quality of reproductive health and family planning counseling lead to acceptance of contraceptives, higher satisfaction and continuation of the method application by the clients (6).
The services providers play a key role in the women’s decision to prevent the pregnancy such as the type of the method and adherence to the method chosen. One of the components of the Bruce framework is to deal with the quality of the family planning services regarding the interpersonal relationships between the clients and the providers (7).
A study in Egypt showed that in the client-centered and high-quality counseling, the client’s satisfaction was higher three times and the continuation of consumption is seven months longer (8). A structured counseling can affect the client’s choice highly; that is, the degree of the method discontinuation will decrease (9).
Furthermore, a review study on intra uterine device (IUD) acceptance showed the women receiving services from the structured counseling services providers consume higher uptake of the IUD compared with women in control groups who received routine care (10). The family planning clients facing some conditions like chronic medical problems ones must assume the responsibility for a method they choose out of different options, monitoring side effects and returning for scheduled check-ups and re-supply(11).
Studies have found that patients or clients who articulate their needs, concerns, and symptoms during consultations will more probably to supply the adequate information providers need to make an accurate diagnosis, select effective treatment, and offer appropriate advice (12).
The research findings in Jordan have shown that one of the reasons for unmet need family planning is the low quality of the family planning counseling services (7).
Unfornatuely some of the counseling don’t have desirable quality due to lack of facilities, time and personnel’s counseling skills of health care shortages (13).
In a study by Simbar ,et al in Iran, despite the sufficient facilities , well-educated personnel and the client’s high satisfaction ,the necessary counseling and educations were not provided and the pregnancy prevention methods is mediocre and insufficient (14).
Thus, the current state of Iran’s population growth which is balanced, the quality of FP services is considered as an important priority.
standards are reliable for evaluation and since the national standard package has been codified using the scientific principles; In this study the degree of counseling services correspondence with the national standards has been examined in Ahvaz city so that, by identifying Existing weak points, we can take steps to obviate the problems and improve the quality of the FP counseling services.
According to the findings of the present study, the services of family planning counseling had a mediocre quality and compliance rate with the standard regarding both the special and the general services which highlights the need for multidimensional interventions to ameliorate the FP counseling in line with the standard.
Also those findings can serve as a base for further studies in this field.
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