Quality characteristics of field workers and contraceptive use dynamics: Lessons from Matlab, Bangladesh

In recent years, the quality of services of the family planning programme has been identified as a fundamental determinant of contraceptive use and continuation, since the potential clients are more sceptical and more concerned with the quality of care than past clients (Hull, 1996; Jain, 1989; Koenig and others, 1997; Mroz and others, 1999; Simmons and Phillips, 1990). However, the quality of care, which consists of a series of varied and interacting factors, has been defined in different ways in different contexts by various experts (Adeokun, 1994; Bertrand and others, 1995; Brown and others, 1995; Bruce, 1990: Hardee and Gould. 1993). hi his classical study. Brace (1990) has identified six elements of quality of care in family planning, such as choice of contraceptive methods, providers’ technical competence, provider-client information exchange, interpersonal relations, mechanisms to encourage continuity of contraceptive use, and appropriate constellation of services. Jain (1989) stated that quality of care refers to the way clients are treated by the system providing sendees. Quality of care, in this sense, places much emphasis on the interpersonal dimension of interactions between providers and clients. In this context, the role of field workers is crucial in fulfilling the demand for quality of care, as they are the programme representatives working at maintaining the important link between the programme and the clients. Clients interact with the programme through outreach staff who promote the practice of contraception, disseminate information and distribute supplies.