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