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      Fundamental elements of the quality of care: a simple framework.

      Studies in family planning

      Time Factors, Quality of Health Care, Quality Control, Patient Education as Topic, Interpersonal Relations, Humans, Health Services Accessibility, Global Health, Female, organization & administration, Family Planning Services, methods, Contraception

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          This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice of methods, information given to clients, technical competence, interpersonal relations, follow-up and continuity mechanisms, and the appropriate constellation of services). The literature is reviewed regarding evidence that improvements in these various dimensions of care result in gains at the individual level; an even scarcer body of literature is reviewed for evidence of gains at the level of program efficiency and impact. A concluding section discusses how to make practical use of the framework and distinguishes three vantage points from which to view quality: the structure of the program, the service-giving process itself, and the outcome of care, particularly with respect to individual knowledge, behavior, and satisfaction with services.

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