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Monitoring quality of care in family planning programs: A comparison of observations and client exit interviews
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Guttmacher InstituteContext: Monitoring quality of care in family planning programs is important, but the complexity and subjectivity of the topic create many challenges.
Methods: The Quick Investigation of Quality (QIQ) was developed to monitor quality of care by using observations of client-provider interactions, exit interviews with clients and facility audits. The QIQ was field-tested in multiple countries in 1998-1999. Using linked data for 583 clients in Ecuador, 539 in Uganda and 736 in Zimbabwe, this analysis examines the comparability of results from observations and exit interviews.
Results: For a given indicator, levels of agreement between data from observations and interviews varied across countries, but within a country, results were consistent between instruments. For the three countries combined, agreement was good to excellent (kappas, 0.47-0.98) on 13 of the 14 indicators examined; observations and exit interviews yielded consistent responses in 63-99% of cases. Agreement was highest on the indicators that measured interpersonal relations. Inconsistencies reflected primarily that clients received information outside of the observed client-provider interaction.