Diagnosing Quality of Reproductive Health Services Provided through Public Health System in India: Application of System's Framework

By Sodani, P. R. | Journal of Services Research, April-September 2006 | Go to article overview

Diagnosing Quality of Reproductive Health Services Provided through Public Health System in India: Application of System's Framework


Sodani, P. R., Journal of Services Research


Quality of care has emerged as a central issue in reproductive health. The need for improving quality is intensely realized, as the health services remain grossly under-utilized despite an extensive network of infrastructure and manpower. The study has been carried out to assess the quality of care of reproductive health services and to determine factors responsible for the current level of quality of reproductive health services in the context of public health system in Udaipur district of a major Indian State Rajasthan. The study is based on both primary and secondary data. It has used both quantitative and qualitative information. Bruce Quality of Care framework has been used to assess the quality of care, which incorporate six elements: choice of methods, information given to users, technical competence, interpersonal relations, follow-up/continuity mechanisms, and appropriate constellation of services. These elements reflect six aspects of the services, identifying client experience as critical. The quantitative score for each indicator has been calculated. The overall score for the quality of care for the district worked out to be 37 on a scale of 0 to 100. This shows that the current situation of quality of care in the district is poor. To determine the factors affecting the current performance of quality of care, a systems approach, using Jain's Diagnostic Model (consisting of five components, viz., Desired Output, Environment, Input, Information, and Process) has been used. After detailed diagnosis of these components, a few vital factors have been identified as highly important, with low favourablity and highly manipulable for improving systems performance.

INTRODUCTION

Quality improvement in providing of reproductive health (RM) services is expected to have an important impact on efficiency, client satisfaction and utilisation (Geyndt, Willy De 1995; Satia, Jay, 1993; and Pathfinder International, 1993). Quality of care is often considered unaffordable for programs with limited financial resources. However, ensuring quality of care is more likely to result in a more efficient use of resources, because the interventions will have greater health benefits. It will result in a larger, more committed clientele of satisfied clients.

Recent attention to the quality of RH services has highlighted the fact that historically, these services have usually been evaluated more in terms of the degree to which they have achieved demographic objectives, such as fertility decline or the reduction of infant and maternal mortality, than in terms of the quality of the services deployed to achieve those outcomes. The quality of routine operations of RH services that daily serve millions of people worldwide and may have significant impacts on both safe and informed contraceptive choices and safe motherhood practices has become the focus of donor and government attention only in the last few years.

India has made considerable progress in the last few decades in expanding the public health system and reducing the burden of disease. The National Health Policy (NHP) of 1983 has set targets for improving the health status of the population and reducing fertility. An extensive infrastructure has been developed during the last decade for public provision of primary health care services. Partly as a result of these efforts, the infant mortality rate (IMR) at the all India level had been reduced to 74 per 1,000 live births by 1994. The situation is more alarming in the case of Rajasthan. The present health care system in Rajasthan is faced with serious problems with respect to efficiency, effectiveness and quality. These problems prevent the health system from achieving the desired outcomes.

Quality of care has emerged as a central issue in reproductive health. The need for improving quality is intensely realized, as the health services remain grossly under-utilized despite an extensive network of infrastructure and manpower. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Diagnosing Quality of Reproductive Health Services Provided through Public Health System in India: Application of System's Framework
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.