Evaluating long-acting reversible contraceptive service quality at Manna Woreda health posts, Southwest Ethiopia: a mixed method study.

Abstract

Background: Long-acting reversible contraception is a key strategy for preventing unintended pregnancies, unbalanced human population growth, and unsafe abortions. There is limited evidence on the quality of long-acting reversible contraceptive services in Ethiopia, particularly in the study area. Therefore, this study aimed to evaluate the quality of long-acting reversible contraception services in the health Posts of Manna Woreda, Southwest Ethiopia.

Method: A case study evaluation design using a mixed method was employed from May 9 to June 25, 2021. Eight health posts were purposively selected from the 26 health posts in Woreda. Client exit interviews, direct observation, 3-month document review, resource inventories, and key informant interviews were also conducted. The quantitative data were entered into Epi-Data version 4.6 and exported to SPSS version 24 for analysis. Qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall quality of program implementation was measured based on predetermined judgmental criteria.

Results: The overall quality of long-acting reversible contraceptive services was 66.8%, with availability at 77.15%, provider compliance with national guidelines at 53.1%, and client satisfaction at 70%. Notable gaps included poor information provision during consultation, absence of supportive supervision, guidelines, and lack of infrastructure and information education materials. Additionally, there were gaps in the provision of services according to national guidelines.

Conclusion: The overall quality status of long-acting reversible contraception services was judged to be good, although service providers' compliance with the national guidelines was fair, and client satisfaction was judged to be good. Shortage of infrastructure, such as electricity, water, guidelines, and information education communication aids. Therefore, the Woreda Health Office should provide guidelines, equipment, and regular supportive supervision to improve the service quality.