Structural Quality of Services and Use of Family Planning Services in Primary Health Care Facilities in Ethiopia. How Do Public and Private Facilities Compare?

Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Yibeltal Assefa, Theodros Getachew Zemedu, Mengistu Kifle and Caroline O. Laurence
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Gizachew Assefa Tessema: School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
Mohammad Afzal Mahmood: School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
Judith Streak Gomersall: School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
Yibeltal Assefa: School of Public Health, The University of Queensland, Brisbane, QLD 4072, Australia
Theodros Getachew Zemedu: Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa 1242, Ethiopia
Mengistu Kifle: Federal Ministry of Health, Addis Ababa, 1234, Ethiopia
Caroline O. Laurence: School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia

IJERPH, 2020, vol. 17, issue 12, 1-11

Abstract: Background: Family planning (FP) is among the important interventions that reduce maternal mortality. Poor quality FP service is associated with lower services utilisation, in turn undermining the efforts to address maternal mortality. There is currently little research on the quality of FP services in the private sector in Ethiopia, and how it compares to FP services in public facilities. Methods: A secondary data analysis of two national surveys, Ethiopia Services Provision Assessment Plus Survey 2014 and Ethiopian Demographic and Health Survey 2016, was conducted. Data from 1094 (139 private, 955 public) health facilities were analysed. In total, 3696 women were included in the comparison of users’ characteristics. Logistic regression was conducted. Facility type (public vs. private) was the key exposure of interest. Results: The private facilities were less likely to have implants (Adjusted Odds Ratio (AOR) = 0.06; 95% Confidence Interval (CI): 0.03, 0.12), trained FP providers (AOR = 0.23; 95% CI: 0.14, 0.41) and FP guidelines/protocols (AOR = 0.33; 95% CI: 0.19, 0.54) than public facilities but were more likely to have functional cell phones (AOR = 8.20; 95% CI: 4.95, 13.59) and water supply (AOR = 3.37; 95% CI: 1.72, 6.59). Conclusion: This study highlights the need for strengthening both private and public facilities for public–private partnerships to contribute to increased FP use and better health outcomes.

Keywords: quality of services; family planning; public–private partnership; primary health care; Ethiopia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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