QUALITATIVE ASSESSMENT OF URBAN FAMILY PLANNING FACILITIES HAMADAN, MAY - SEPTEMBER 2003

This cross-sectional study was conducted from May to September 2003, with the aim of determining quality of service in 25 State-run family planning clinics in Hamadan city. A total of 400 consultations were observed and assessed using UNICEF quality checklists. Results showed that less than 50% of the clients are receiving service of a satisfactory quality; areas of care where quality was worst included history taking, physical examination and counseling. It became apparent that care providers with higher education had lower performance levels compared to their less educated colleagues. Service for new clients was of poorer quality than for those who had requested a change of contraceptive method. Furthermore, earlier hours of a work shift (before 10 o’clock) were associated with better service quality than later hours. Altogether, the study reveals serious flaws in areas such as training of family health workers and human resource management within the current system. To address these shortcomings, we recommend a more client-oriented approach in health care, use of supplementary material to promote client knowledge, and training of health workers with due emphasis on effective communication and performance.