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1、Hutchinsonetal.BMCHealthServicesResearch2011,11:203http://www.biomedcentral.com/1472-6963/11/203RESEARCHARTICLEOpenAccessMeasuringclientsatisfactionandthequalityoffamilyplanningservices:AcomparativeanalysisofpublicandprivatehealthfacilitiesinTanzania,KenyaandGhana1*†1†2†PaulLHutch
2、inson,MaiDoandSohailAghaAbstractBackground:Publicandprivatefamilyplanningprovidersfacedifferentincentivestructures,whichmayaffectoverallqualityandultimatelytheacceptabilityoffamilyplanningfortheirintendedclients.Thisanalysisseekstoquantifydifferencesinthequalityoffamilyplanning(FP
3、)servicesatpublicandprivateprovidersinthreerepresentativesub-SaharanAfricancountries(Tanzania,KenyaandGhana),toassesshowthesequalitydifferentialsimpactuponFPclients’satisfaction,andtosuggesthowqualityimprovementscanimprovecontraceptivecontinuationrates.Methods:Indicesoftechnical,s
4、tructuralandprocessmeasuresofqualityareconstructedfromServiceProvisionAssessments(SPAs)conductedinTanzania(2006),Kenya(2004)andGhana(2002)usingdirectobservationoffacilityattributesandclient-providerinteractions.Marginaleffectsfrommultivariateregressionscontrollingforclientcharacte
5、risticsandthemulti-stageclustersampledesignassesstherelativeimportanceofdifferentmeasuresofstructuralandprocessqualityatpublicandprivatefacilitiesonclientsatisfaction.Results:Privatehealthfacilitiesappeartobeofhigher(interpersonal)processqualitythanpublicfacilitiesbutnotnecessaril
6、yhighertechnicalqualityinthethreecountries,thoughthesedifferentialsareconsiderablylargeratlowerlevelfacilities(clinics,healthcenters,dispensaries)thanathospitals.Familyplanningclientsatisfaction,however,appearsconsiderablyhigheratprivatefacilities-bothhospitalsandclinics-mostlikel
7、yattributabletobothprocessandstructuralfactorssuchasshorterwaitingtimesandfewerstockoutsofmethodsandsupplies.Conclusions:Becausethepublicsectorrepresentsthemajorsourceoffamilyplanningservicesindevelopingcountries,governmentsandMinistriesofHealthshouldcontinuetoimplementandtoencour
8、ageincentives,perhapsperformance-
