ArticleMalawi medical journal : the journal of Medical Association of Malawi2016
Quality of facility-based family planning services for adolescents in Malawi: Findings from a national census of health facilities.
Article in Malawi medical journal : the journal of Medical Association of Malawi, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Quality of sexual and reproductive health services for adolescents and young people in public health facilities in Southwest Nigeria: a mystery client study.Global health action · 2022Article
- From raw data to a score: comparing quantitative methods that construct multi-level composite implementation strength scores of family planning programs in Malawi.Population health metrics · 2022Article
- Preventing, but Not Caring for, Adolescent Pregnancies? Disparities in the Quality of Reproductive Health Care in Sub-Saharan Africa.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2022Article
- Article
- Comparing summary measures of quality of care for family planning in Haiti, Malawi, and Tanzania.PloS one · 2019Article
- Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.Journal of global health · 2017Article
- Communication, social norms, and contraceptive use among adolescent girls and young women in Lilongwe, Malawi.Women & healthArticle
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Authors and funding
3 authors.
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Abstract
backgroundThe main objective of this study was to describe the quality, in terms of provision and experience of care, of facility-based family planning services for adolescents compared to older clients in Malawi.
methodsSecondary data analysis was performed on data obtained from the Service Provision Assessment survey 2013-14, a census of all formal health facilities in the country. For the present study the inclusion criterion was that the client's age was recorded in the data set, which gave a weighted total of 1388 observations of consultations, reflecting provision of care, and client exit interviews, reflecting experience of care.
resultsThe youngest clients (age group 13 to 19 years) had twice the odds of reporting a better experience of care compared to clients aged 26 and older (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.15 to 3.54, P = 0.013). The standard of observed provision was low, typically with half or more of the mandated elements of care omitted. Compared with clients aged over 25, provision of care was slightly better for adolescents, with a coefficient of 4.56 on a percentage scale (95% CI 0.90 to 8.23, P = 0.015) and a coefficient of 2.33 for those aged 20-25 (95% CI 0.21 to 4.44, P = 0.032). Clients seen in facilities under nongovernmental management had better provision of care compared to government facilities, with a coefficient of 12.35 (95% CI 6.70 to 18.01, P < 0.001); care was worse for clients seen in clinics compared to hospitals (coefficient -6.88, 95% CI -11.41 to -2.35, P = 0.003) and also for clients seen by health surveillance assistants compared to those seen by a clinician (coefficient -9.41, 95% CI -15.53 to -3.29, P = 0.003).
conclusionsQuality of care for adolescents attending facility-based family planning services was slightly better than for older clients, but this is overshadowed by the finding of a low standard of care overall. Health system strengthening, especially at the clinic level, is a policy and programming priority that will contribute to adolescent reproductive health in Malawi.
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