Caitlin R Williams, Laura E Britton, Brooke W Bullington, Debborah Muthoki Wambua, Dickens Otieno Onyango, Katherine Tumlinson
{"title":"Frequency and impact of long wait times for family planning in public-sector healthcare facilities in Western Kenya.","authors":"Caitlin R Williams, Laura E Britton, Brooke W Bullington, Debborah Muthoki Wambua, Dickens Otieno Onyango, Katherine Tumlinson","doi":"10.1080/16549716.2022.2128305","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long wait times for family planning services are a barrier to high quality care and client satisfaction. Existing literature examining family planning wait times has methodological limitations, as most studies use data collected during exit interviews, which are subject to recall, courtesy, and selection bias.</p><p><strong>Objective: </strong>We sought to employ a mixed methods approach to capture the prevalence, length, causes, and impacts of wait times for family planning services in Western Kenya.</p><p><strong>Methods: </strong>We used mystery clients, focus groups, key informant interviews, and journey mapping workshops to measure and describe family planning wait times. Fifteen mystery clients visited 60 public-sector facilities to quantitatively capture wait times. We conducted eight focus group discussions with 55 current or former family planning clients and 19 key informant interviews to understand facility-level barriers to family planning and feasible solutions. Finally, we visualized the process of seeking and providing family planning with journey mapping workshops with nine clients and 12 providers.</p><p><strong>Results: </strong>Mystery clients waited, on average, 74 minutes to be seen for family planning services. In focus group discussions and key informant interviews, three themes emerged: the nature of wait times, the impact of wait times, and how to address wait times. Clients characterized long wait times as a barrier to achieving their reproductive desires. Key informants perceived provider shortages to cause long wait times, which reduced quality of family planning services. Both providers and family planning clients suggested increasing staffing or offering specialization to decrease wait times and increase quality of care.</p><p><strong>Conclusion: </strong>Our mixed methods approach revealed that wait times for family planning services were common, could be extensive, and were viewed as a barrier to high quality of care by clients, providers, and key informants. Across the board, participants felt that addressing workforce shortages would enhance service delivery and thus promote reproductive autonomy among women in Kenya.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543147/pdf/","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Health Action","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/16549716.2022.2128305","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 1
Abstract
Background: Long wait times for family planning services are a barrier to high quality care and client satisfaction. Existing literature examining family planning wait times has methodological limitations, as most studies use data collected during exit interviews, which are subject to recall, courtesy, and selection bias.
Objective: We sought to employ a mixed methods approach to capture the prevalence, length, causes, and impacts of wait times for family planning services in Western Kenya.
Methods: We used mystery clients, focus groups, key informant interviews, and journey mapping workshops to measure and describe family planning wait times. Fifteen mystery clients visited 60 public-sector facilities to quantitatively capture wait times. We conducted eight focus group discussions with 55 current or former family planning clients and 19 key informant interviews to understand facility-level barriers to family planning and feasible solutions. Finally, we visualized the process of seeking and providing family planning with journey mapping workshops with nine clients and 12 providers.
Results: Mystery clients waited, on average, 74 minutes to be seen for family planning services. In focus group discussions and key informant interviews, three themes emerged: the nature of wait times, the impact of wait times, and how to address wait times. Clients characterized long wait times as a barrier to achieving their reproductive desires. Key informants perceived provider shortages to cause long wait times, which reduced quality of family planning services. Both providers and family planning clients suggested increasing staffing or offering specialization to decrease wait times and increase quality of care.
Conclusion: Our mixed methods approach revealed that wait times for family planning services were common, could be extensive, and were viewed as a barrier to high quality of care by clients, providers, and key informants. Across the board, participants felt that addressing workforce shortages would enhance service delivery and thus promote reproductive autonomy among women in Kenya.
期刊介绍:
Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research.
Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health.
Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.