1. % of Women Pleased or Very Pleased with Aspects of Provider Attitude
Assessing Client Satisfaction of Safe Medical Abortion Services Through a Private Franchise in Cambodia
Meredith Center, Deputy Executive Director for Programs, PSI/Cambodia
% of Women Pleased or Very Pleased with Aspects of Provider Attitude
BACKGROUND
Abortion was legalized in Cambodia in 1997, but remains somewhat stigmatized. As abortion became more widely available, abortion services were monitored for quality, such as whether women are receiving sufficient counseling. However, a women’s satisfaction in her experience is also an important measure of quality. PSI/Cambodia (PSI/C) therefore conducted a client satisfaction survey in order to assess satisfaction related to abortion services received from a Sun Quality Health Network (SQHN) provider, a network of private providers who receiving training an ongoing quality assurance activities from PSI/C.
*n = 23
METHODS
% of Women Pleased or Very Pleased with Different Aspects of Medical Abortion Services
Exit survey of women who received any abortion service (either medical or surgical abortion) from a SQHN provider, using a standardized questionnaire, with satisfaction questions commonly using a 5-point Likert scale.
171 clients from 30 SQHN providers were interviewed in December 2016, with 13% (n=23) under the age of 25.
30 SQHN providers within 14 provinces were selected using probability sampling approach among providers who provide both abortion and post-abortion care services.
Data was analyzed using descriptive statistics and bivariate analysis.
RESULTS
Women expressed high levels of satisfaction with the safe abortion service they received, with 76% saying the services exceeded their expectations, and 87% saying they were satisfied or very satisfied with the experience.
A variety of factors measured through the study appeared to contribute to the high overall level of satisfaction observed, such as:
82% of women were pleased or very pleased with the hours of the facility
87% of women were please or very pleased with the comfort of the waiting area
90% of women were pleased or very pleased with the facility cleanliness
88% of women were pleased or very pleased with the total length of time the client spent at the facility
The factor that received the lowest level of satisfaction was the cost of the service, which only 57% were pleased or very pleased with.
Among the highest rating in the survey was the friendliness of the provider, for which 91% of clients were either pleased or very pleased. However, satisfaction with provider attitude decreased sharply when the client was under 25 years old, as only 39% of these clients said they were pleased or very pleased with their treatment as a young person.
CONCLUSION
Given the restrictions on abortion in many countries, research from Cambodia where abortion is legal, shows that private providers can offer safe abortion services that are satisfactory to clients.
The research also provided important programmatic information for PSI/C. For example, PSI/C learned more about the reasons why clients choose a SQHN provider for a medical abortion, rather than a pharmacy, where medical abortion is also available; 90% of medical abortion clients in our sample reported wanting the advice of a provider before making a decision.
Finally, the research identified an important area of improvement for PSI/C and the SQHN providers to increase the friendliness of services for youth. In Cambodia, it is widely believed that young women face some discrimination when seeking family planning services, but this study provides evidence that this discrimination extends to young women receiving abortion services. In 2017 and 2018, PSI/C trained all of the SQHN providers on youth-friendly services and is developing posters to place at SQHN to advertise confidential and friendly services for youth.
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