Diagnosing Quality Of Reproductive Health Services Provided Through Public Health System In India: Application Of System’s Framework | P. R. Sodani

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.