Improving quality of care

Perceived quality of care is an important factor that determines whether people choose to utilise SRH services. Evidence from Bangladesh, Senegal and Tanzania suggests that in areas where women felt that they were receiving a high standard of care, they were more likely to use contraceptives than in areas with lower quality health facilities.

Improving quality of care requires that patients’ perspectives and levels of satisfaction are taken into account when evaluating services, and are incorporated into policy decisions. This means that in addition to clinical factors (safe procedures, accurate information and reliable products), providers need to be aware of their patients’ cultural values, social concerns and individual needs. Factors that patients often consider important in determining quality of care include: acceptable waiting times; convenient opening hours; confidential relationships; availability of gender-sensitive services; continuity of services; choice of contraceptive method; and being treated with dignity and respect.

EngenderHealth, a non-profit organisation that works in reproductive health, has devised a "client-orientated, provider-efficient" (COPE) approach to improve quality of care and motivate staff. COPE offers guidance for providers to assess their services, interview patients, and examine the time that they spend at clinics. This gives staff a better understanding of patients' perspectives, and enables them to develop a plan of action to improve quality. In some clinics, COPE has resulted in staff staggering their lunch breaks to reduce patients' waiting time. The approach empowers providers to have more control over their activities and resources, and motivates staff to identify their own training needs (see Engenderhealth).