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The Population Council continues to resist setting quality of care standards for family planning programs. It contends that professionals responsible for each family planning program must define intended and achievable levels of care. The Population Council does claim, however, that a high quality program is client-oriented and assists clients in reaching their reproductive goals. Even though a high quality program would reduce fertility by increasing contraceptive use, it must not execute fertility reduction policies that conflict with clients' well being. 6 components of quality care include appropriate choice of methods, responsible information, technical competence, interpersonal relations, mechanisms to encourage continuity, and appropriate mixture of services. A key problem with setting universal standard is that each country or program must validate the standards and make them work. For example, standards may require providers to understand clients' reproductive intentions and to help them choose a method which meets their needs, yet the standards cannot define how they should do so. The standard setting process for individual countries and programs should include the technical and affective aspects of care and address the following: What quality of care does a program propose to offer, can it offer, is actually offered, and is received by clients? Rapid assessment techniques can be used to compare the quality of care a program wants to offer and the care that is actually given to clients. Program managers can then discern gaps between intention and reality and reasons to improve service standards. In conclusion, solutions to problems with quality of family planning care are only found locally.
Jain et al. (Sun,) studied this question.