ASSESSMENT OF QUALITY OF FAMILY PLANNING SERVICES AND ASSOCIATED FACTORS AMONG HEALTH FACILITIES IN EZHA DISTRICT GURAGE ZONE, SOUTHERN REGION, ETHIOPIA

Abstract

Family planning programs have played a significant role in reducing fertility rates in developing countries by providing accessible education and resources on contraception, enabling informed decision-making and improved family planning. This study aimed to assess the quality of family planning services and its associated factors among health facilities in Ezha District, Gurage Zone, Southern Region, Ethiopia. A facility-based cross sectional study was conducted from June 5 to August 20, 2023, involving 419 reproductive age women attending a family planning unit. Data were collected through structured questionnaires and analyzed using descriptive statistics, bivariate and multivariable logistic regression analyses. Qualitative data were analyzed using thematic content analysis. The study included 401 clients, with an overall response rate of 95.7%. The clients' satisfaction with family planning services was 67.1% (95% CI 0.644-0.698). Satisfaction was higher among clients who received clear explanations of the process (AOR = 3.6, 95% CI 1.96-6.40), had privacy during consultation, and received their preferred contraceptive method. Clients who visited health facilities for the first time and perceived the provider as easy to understand reported higher satisfaction. Protestant and Orthodox clients had significantly lower satisfaction compared to the Muslim reference group with adjusted odds ratios of 0.30 (95% CI 0.12-0.80) and 0.31 (95% CI 0.12-0.81), respectively. The study identified constraints in the delivery of quality family planning care, with moderate satisfaction levels among clients. Key factors influencing satisfaction included clear explanations of methods, respectful treatment, and privacy during consultations. Establishing a robust feedback mechanism involving clients is crucial for improving service quality. Addressing modifiable barriers for religious groups and implementing regular trainings for service providers are essential for enhancing satisfaction levels and delivering high-quality family planning care.