145 lines
4.8 KiB
YAML
145 lines
4.8 KiB
YAML
|
abstract: 'Background Women seeking family planning services from public-sector
|
||
|
|
|
||
|
|
facilities in low- and middle-income countries sometimes face
|
||
|
|
|
||
|
|
provider-imposed barriers to care. Social accountability is an approach
|
||
|
|
|
||
|
|
that could address provider-imposed barriers by empowering communities
|
||
|
|
|
||
|
|
to hold their service providers to account for service quality. Yet
|
||
|
|
|
||
|
|
little is known about the feasibility and potential impact of such
|
||
|
|
|
||
|
|
efforts in the context of contraceptive care. We piloted a social
|
||
|
|
|
||
|
|
accountability intervention-the Community Score Card (CSC)-in three
|
||
|
|
|
||
|
|
public healthcare facilities in western Kenya and use a mix of
|
||
|
|
|
||
|
|
quantitative and qualitative methodologies to describe the feasibility
|
||
|
|
|
||
|
|
and impact on family planning service provision. Methods We implemented
|
||
|
|
|
||
|
|
and evaluated the CSC in a convenience sample of three public-sector
|
||
|
|
|
||
|
|
facility-community dyads in Kisumu County, Kenya. Within each dyad,
|
||
|
|
|
||
|
|
communities met to identify and prioritize needs, develop corresponding
|
||
|
|
|
||
|
|
indicators, and used a score card to rate the quality of family planning
|
||
|
|
|
||
|
|
service provision and monitor improvement. To ensure young, unmarried
|
||
|
|
|
||
|
|
people had a voice in identifying the unique challenges they face, youth
|
||
|
|
|
||
|
|
working groups (YWG) led all CSC activities. The feasibility and impact
|
||
|
|
|
||
|
|
of CSC activities were evaluated using mystery client visits,
|
||
|
|
|
||
|
|
unannounced visits, focus group discussions with YWG members and
|
||
|
|
|
||
|
|
providers, repeated assessment of score card indicators, and service
|
||
|
|
|
||
|
|
delivery statistics. Results The involvement of community health
|
||
|
|
|
||
|
|
volunteers and supportive community members - as well as the willingness
|
||
|
|
|
||
|
|
of some providers to consider changes to their own behaviors-were key
|
||
|
|
|
||
|
|
score card facilitators. Conversely, community bias against family
|
||
|
|
|
||
|
|
planning was a barrier to wider participation in score card activities
|
||
|
|
|
||
|
|
and the intractability of some provider behaviors led to only small
|
||
|
|
|
||
|
|
shifts in quality improvement. Service statistics did not reveal an
|
||
|
|
|
||
|
|
increase in the percent of women receiving family planning services.
|
||
|
|
|
||
|
|
Conclusion Successful and impactful implementation of the CSC in the
|
||
|
|
|
||
|
|
Kenyan context requires intensive community and provider sensitization,
|
||
|
|
|
||
|
|
and pandemic conditions may have muted the impact on contraceptive
|
||
|
|
|
||
|
|
uptake in this small pilot effort. Further investigation is needed to
|
||
|
|
|
||
|
|
understand whether the CSC - or other social accountability efforts -
|
||
|
|
|
||
|
|
can result in improved contraceptive access.'
|
||
|
|
affiliation: 'Onyango, DO (Corresponding Author), Kisumu Cty Dept Hlth, Kisumu, Kenya.
|
||
|
|
|
||
|
|
Onyango, DO (Corresponding Author), Univ Med Ctr, Julius Ctr Hlth Sci \& Primary
|
||
|
|
Care, Julius Global Hlth, Utrecht, Netherlands.
|
||
|
|
|
||
|
|
Onyango, Dickens Otieno, Kisumu Cty Dept Hlth, Kisumu, Kenya.
|
||
|
|
|
||
|
|
Onyango, Dickens Otieno, Univ Med Ctr, Julius Ctr Hlth Sci \& Primary Care, Julius
|
||
|
|
Global Hlth, Utrecht, Netherlands.
|
||
|
|
|
||
|
|
Tumlinson, Katherine; Chung, Stephanie, Univ N Carolina, Dept Maternal \& Child
|
||
|
|
Hlth, Gillings Sch Global Publ Hlth, Chapel Hill, NC 27515 USA.
|
||
|
|
|
||
|
|
Tumlinson, Katherine; Bullington, Brooke W., Univ N Carolina, Carolina Populat Ctr,
|
||
|
|
Chapel Hill, NC 27515 USA.
|
||
|
|
|
||
|
|
Bullington, Brooke W., Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Epidemiol,
|
||
|
|
Chapel Hill, NC 27515 USA.
|
||
|
|
|
||
|
|
Gakii, Catherine, Innovat Poverty Act Kenya IPA K, Nairobi, Kenya.
|
||
|
|
|
||
|
|
Senderowicz, Leigh, Univ Wisconsin, Sch Med \& Publ Hlth, Dept Obstet \& Gynecol,
|
||
|
|
Madison, WI USA.'
|
||
|
|
article-number: '1960'
|
||
|
|
author: Onyango, Dickens Otieno and Tumlinson, Katherine and Chung, Stephanie and
|
||
|
|
Bullington, Brooke W. and Gakii, Catherine and Senderowicz, Leigh
|
||
|
|
author-email: macdickens2002@gmail.com
|
||
|
|
author_list:
|
||
|
|
- family: Onyango
|
||
|
|
given: Dickens Otieno
|
||
|
|
- family: Tumlinson
|
||
|
|
given: Katherine
|
||
|
|
- family: Chung
|
||
|
|
given: Stephanie
|
||
|
|
- family: Bullington
|
||
|
|
given: Brooke W.
|
||
|
|
- family: Gakii
|
||
|
|
given: Catherine
|
||
|
|
- family: Senderowicz
|
||
|
|
given: Leigh
|
||
|
|
da: '2023-09-28'
|
||
|
|
doi: 10.1186/s12889-022-14388-y
|
||
|
|
eissn: 1471-2458
|
||
|
|
files: []
|
||
|
|
journal: BMC PUBLIC HEALTH
|
||
|
|
keywords: 'Social accountability; Contraception; Quality of care; Kenya; Mystery
|
||
|
|
|
||
|
|
clients; Sub-Saharan Africa; Provider bias'
|
||
|
|
keywords-plus: HEALTH SECTOR; PROVIDERS; ACCESS
|
||
|
|
language: English
|
||
|
|
month: OCT 24
|
||
|
|
number: '1'
|
||
|
|
number-of-cited-references: '28'
|
||
|
|
orcid-numbers: 'Tumlinson, Katherine/0000-0001-8314-8219
|
||
|
|
|
||
|
|
Bullington, Brooke/0000-0002-3341-087X
|
||
|
|
|
||
|
|
Chung, Stephanie/0000-0002-2383-0512
|
||
|
|
|
||
|
|
Senderowicz, Leigh/0000-0002-6713-1473'
|
||
|
|
papis_id: 7df98755cbc19ad68a95e481d1daaedb
|
||
|
|
ref: Onyango2022evaluatingfeasibilit
|
||
|
|
researcherid-numbers: 'Tumlinson, Katherine/E-6975-2013
|
||
|
|
|
||
|
|
'
|
||
|
|
times-cited: '0'
|
||
|
|
title: Evaluating the feasibility of the Community Score Card and subsequent contraceptive
|
||
|
|
behavior in Kisumu, Kenya
|
||
|
|
type: Article
|
||
|
|
unique-id: WOS:000871406300003
|
||
|
|
usage-count-last-180-days: '0'
|
||
|
|
usage-count-since-2013: '0'
|
||
|
|
volume: '22'
|
||
|
|
web-of-science-categories: Public, Environmental \& Occupational Health
|
||
|
|
year: '2022'
|