ASSESSMENT OF QUALITY OF CONTRACEPTIVE COUNSELLING SERVICES IN PUBLIC HEALTH FACILITIES OF ZAMFARA STATE BY AMINA AHMAD DEPARTMENT OF NURSING SCIENCES, FACULTY OF ALLIED HEALTH SCIENCES, COLLEGE OF MEDICAL SCIENCES, AHMADU BELLO UNIVERSITY, ZARIA 2021
ASSESSMENT OF QUALITY OF CONTRACEPTIVE COUNSELLING SERVICES IN PUBLIC HEALTH FACILITIES OF ZAMFARA STATE BY AMINA AHMAD DEPARTMENT OF NURSING SCIENCES, FACULTY OF ALLIED HEALTH SCIENCES, COLLEGE OF MEDICAL SCIENCES, AHMADU BELLO UNIVERSITY, ZARIA 2021
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Date
2021
Authors
AHMAD, Amina
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Abstract
Contraceptive counselling for rightful decision making in family planning methods
selection is one important reproductive right of a woman. The study aimed to assess quality
of contraceptive counselling services in public health facilities of Zamfara state. The study
identified the number of formally/certified FP trained service providers, assessed quality of
contraceptive counselling, identified number of client‗s offered, pattern of contraceptive
method mix in the last six month preceding the study and client‗s satisfaction with service
provision. A concurrent mixed method study design (qualitative and quantitative) method
was employed for the study. Seven (7) public health care facilitiesout of the 22 available
hospitals were selected for the study through multi-stagesampling technique from which 48
clients were interviewed. The tools for data collectionwere an observation guide and an
interview checklist adopted from Kim (1995) used to elicit responses of the respondents
via overt non-participant observations during counselling sessions, client exit interviews
and clients` satisfaction with the service provision. Service delivery registers of the
selected facilities were scrutinized for availability of contraceptive method mix in the last
six months prior to survey. The number of formally trained FP providers in the selected
facilities was obtained from the state MCH coordinator and corroborated at the facilities
from the respective head of the FP clinics. Data from Client Exit Interview (CEI) was
transcribed in Hausa and translated into English by a translation expert which was
subsequently analysed manually using thematic content methodology. The reports from the
observations of the counselling sessions were coded and also analyzed manually. The data
on contraceptive method mix was analyzed using excel spread sheet 2010 and presented in
a table and simple percentages. Pearson correlation coefficient was used to test relationship
between variables at p-value of 0.05. Findings revealed that most of the respondents are
within the reproductive age 20-39 years with range between 4-6 parity haven the highest %
of 39.5. Majority had secondary education and all were married (100%). The quality of
client-provider interaction was found to be poor as evaluated by the researcher and
reported by the respondents. Trained service providers were in short supply with 50%.
Nearly 4,000 clients were offered various contraceptive method mix in which the injectable
was the commonest method accounting for one quarter of these clients followed closely by
the implant with 34.7%, despite poor client-provider interaction, clients were still satisfied
with some aspect of counselling such as greeting, provision of free contraceptive and
information they received from their service providers. Correlation was seen between
various subset of the client satisfaction and socio-demographic characteristics; occupation
and parity were found to be correlated with counselling session (p=0.012) and (0.050)
respectively. The findings suggest the need for increase awareness and enlightment on FP
counselling to women through mass media, mass employment by the government to
address shortages and the need for FP providers to be specifically trained on contraceptive
counselling techniques to improve the quality of FP counselling services in public health
facilities in Zamfara state.
Key: ServiceQuality, Contraceptive Counselling, Method Mix, Service Providers
Description
A THESIS SUBMITTED TO THE SCHOOL OF POSTGRADUATE STUDIES,
AHMADU BELLO UNIVERSITY, ZARIA IN PARTIAL FULFILLMENT FOR
THE AWARD OF MASTER DEGREE IN NURSING SCIENCE
DEPARTMENT OF NURSING SCIENCES,
AHMADU BELLO UNIVERSITY,
ZARIA, NIGERIA
Keywords
QUALITY,, CONTRACEPTIVE COUNSELLING SERVICES,, PUBLIC HEALTH FACILITIES,, ZAMFARA STATE