Quality of care in family planning programmes: a rapid assessment in Burkina Faso

The family planning programme in Burkina Faso is relatively new, with services being provided through public sector clinics since 1985. The government strongly supports family planning and is seeking to expand and improve the current programme. To be able to plan for this effectively, the Ministry of Health and Social Action undertook a study to rapidly assess both the functional capacity of the programme's subsystems (for example, logistics, equipment, recordkeeping, IEC activities and service delivery), and the quality of services being offered at the clinic level. A new approach to rapid assessment, termed a ‘situation analysis’, was used for the study, in which research teams visited a sample of 53 clinics to collect a wide range of data through a combination of interviewing and observation techniques. The methodology employs the framework of quality of care conceptualized by Bruce, presenting empirical evidence on the quality of services currently being provided, and suggestions for how quality may be improved to address specific problems through discrete interventions. The use of simple, clear data collection instruments and immediate data entry and tabulation enabled the data to be presented to policymakers a few weeks after fieldwork was completed. Moreover, the results were presented in a form that was easily communicated and stressed practical decision-related issues. The results were disseminated widely within the Ministry and have been used to guide the next phase of strategic planning for the programme. Although used as a diagnostic tool in this study, the situation analysis approach could also be used in a longitudinal design to evaluate a programme's progress over time in improving quality of care and functional capacity.