Process evaluation of long acting family planning program in public health facilities of soro district, hadiya zone, southern Ethiopia

Abstract

Background: Long-acting family planning is a low-cost yet effective way to lower maternal mortality by reducing the number of high-risk births. These methods can enhance family planning programs in meaningful ways if challenges to their availability, access, and acceptability can be overcome. Yet several strong barriers persist in sub-Saharan Africa including Ethiopia, the availability of materials and equipment and trained health provider were some of the limitation for the program. This evaluation research was intended to assess the implementation of long acting family planning service provision and show the areas of improvement for future implementation. Objective: the objective of this process evaluation was to assess the implementation status of long acting family planning program in public health facility of Soro district, Hadiya Zone, 2016. Method: A facility based case study design with quantitative and qualitative data collection methods was employed with all health centers and randomly selected 30% health posts of Soro district from March 07- April 5, 2016. The evaluation was focused on process part of the program with dimensions; availability, compliance and client satisfaction in the dimension of accommodation. Resource inventory, document review; key informant interviews and observations were conducted. Client satisfaction was assessed through exit interview; with sample size of 381. The qualitative data was analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 20 software. Bivariate and multivariate logistic regressions were done to determine the predictor of client satisfaction. The finding of this evaluation were computed and compared with preset criteria for the final judgment. Result: Majority of the health facilities were had only one trained health care providers (78.6%) on long acting family planning. Around 59% and 39% of the health facilities were have light source and taped water respectively. Only one health facility has separate room for family planning and about 30% health facilities were had National FP guideline. About 66% of the required resources for provision of long acting family planning were available which was FAIR in judgmental. The data were collected from 381 respondents. Clients were informed about the methods only 61.4% client told the possibility of switching. The result for compliance was fallen under category of GOOD in score of 76.4%. About 61% of the clients were satisfied on service provided by public health facilities of Soro district. Distance travel, education level, frequency of visit and plan when to have the next child were predictors of client satisfaction with FAIR in judgmental. Conclusion and Recommendation: the overall implementation of long acting family planning service in public health facilities of Soro district was FAIR with the overall achievement in three dimensions was 70.8% pre-sated agreed judgment criteria during evaluability assessment. It is recommended that, to stop malpractice provision of the service by untrained provider, access health facilities to basic infrastructures and other recommendations to improve the program.