MEASUREMENT OF THE QUALITY OF FAMILY-PLANNING-SERVICES

The quality of health services is a subject of increasing interest to health care providers and organizations responsible for financing and promoting health services. The importance of the client's perspective (and by inference, the perspective of potential clients, as well) is n ow well established, but efforts to define and measure quality have th us far been limited to the perspective of experts even when the expert s claim to speak for the clients. In this paper we utilize family plan ning programs to explore issues of the quality of health services. We propose that a better understanding of the view of quality actually he ld by family planning program clients will clarify the influence of qu ality on the use of services, a clarity that has not been possible by looking at quality only as defined by providers, managers or experts. We review the literature on quality of services and identify the gaps in research that must be filled if a better understanding of what qual ity is and how it relates to service outcomes is to be obtained. A fir st step must be the research required to develop a set of measures of quality that reflects the multi-dimensional nature of quality, include s the clients' view of services in the definition of quality, and inco rporates methodologies required to ascertain the true view of clients. Finally, we suggest that dimensions of quality identified as importan t for 'clients' as a group will be more predictive of use of services than dimensions identified as important to 'providers'.