Measuring and Monitoring Quality of Care in Family Planning: Are We Ignoring Negative Experiences?

Shannon Harris, Independent Consultant
Laura J. Reichenbach, Population Council
Karen Hardee, Population Council

Family planning programs have long focused on measuring quality of care in service delivery. This paper reports on a review of family planning literature for quantitative tools that measure negative client experiences described using a maternal health disrespect and abuse framework. Twelve quantitative measurement tools were reviewed in-depth for measures related to non-consented care, non-dignified care, discrimination, and non-confidential care. Individual measures on each tool were mapped to these constructs and a gap analysis was performed. The majority of current family planning indicators focus on measuring positive constructs e.g. voluntarism and informed choice. This analysis shows that current measures do not describe or capture the prevalence of negative client experiences that may impact family planning program outcomes. There is a need for new measures that provide information about negative client experiences, can inform program improvement, and are sensitive to the political and programmatic implications of such measures in family planning.