International Journal for Quality in Health Care Advance Access originally published online on February 3, 2009
International Journal for Quality in Health Care 2009 21(2):87-96; doi:10.1093/intqhc/mzp002
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The quality of family planning services and client satisfaction in the public and private sectors in Kenya
1 Population Services International, Karachi, Pakistan
2 International Health and Development, Tulane University, New Orleans, LA, USA
Objectives. To compare the quality of family planning services delivered at public and private facilities in Kenya.
Methods. Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client–provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome.
Results. Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care.
Conclusions. Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.
Keywords: quality indicators, patient outcomes, patient satisfaction, surveys, reproductive health
Address reprint requests to: Sohail Agha; Tel: +92-21-5838841; Fax: +92-21-5867891; E-mail: sagha{at}greenstar.org.pk
Accepted for publication December 18, 2008.