Table 1 Elements of Bruce’s evidence-based quality of family planning care framework
From: Renewing focus on family planning service quality globally
Element | Definition | Potential impact |
|---|---|---|
Choice of methods | Number of available contraceptive methods | • Increased uptake of contraception [22, 23] • Increased continuation due to method flexibility allowing switching instead of stopping altogether [42] • Selected method that meets client’s specific needs [43, 44] • Increased likelihood that at least one method will be available, especially in settings with frequent stock-outs |
Information given to users | Knowledge conveyed about available contraceptive methods including how to use, benefits and risks, and potential side effects | • Increased uptake of contraception due to dispelled myths and misconceptions [45] • Increased continuation rates due to recognition and management of side effects [46] |
Technical competence | Correct and consistent application of medical eligibility criteria and routinely completing procedures to a defined standard | • Reduced risk of side effects and complications due to appropriate application of the WHO Medical Eligibility Criteria • Reduced risk of infection and improper placement of subdermal implants and intra-uterine devices [47] |
Interpersonal relations | Treating clients with honesty, sympathy and understanding | • Increased uptake and continuation due to being treated with dignity and respect [48–50] |
Follow-up or continuity mechanisms | Establishing when and how clients will return to clinic | • Decreased fertility rates due to increased contraceptive continuation rates [51] |
Appropriate constellation of services | Making contraception readily available to clients regardless of where they access care | • Increased access to contraception via service integration, mobile delivery of services, and task-shifting |