Predictors of quality of family planning counselling in Ethiopia: multilevel analysis of the SPA survey 2021/22
Kalayu Brhane Mruts, Tesfay Brhane Gebremariam, Amanuel Tesfay Gebremedhin

TL;DR
This study finds that family planning counselling in Ethiopia is often of low quality, with provider and facility factors being key influences.
Contribution
The study identifies specific client-, provider-, and facility-level predictors of high-quality family planning counselling in Ethiopia.
Findings
Only 32% of women received high-quality family planning counselling, with key information often missing.
Provider experience and adherence to guidelines were strongly associated with better counselling quality.
Facility-level factors accounted for about 52% of the variation in counselling quality across regions.
Abstract
High-quality family planning (FP) counselling is essential for informed contraceptive choice, reducing discontinuation, and improving reproductive health. However, many women in sub-Saharan Africa continue to face barriers. This study examined client-, provider-, and facility-level determinants of FP counselling quality in Ethiopia using nationally representative, multi-source data. We analysed data from the 2021/22 Ethiopia Service Provision Assessment, including 2,224 women who received or were prescribed injectables, pills, or implants. Counselling quality was assessed using a 15-item checklist derived from direct observations and client exit interviews. Multilevel ordinal logistic regression was applied to identify predictors at the client-, provider-, and facility-levels. Only 32% of clients received high-quality FP counselling, with key information on side effects, STI…
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Taxonomy
TopicsGlobal Maternal and Child Health · Reproductive Health and Contraception · Adolescent Sexual and Reproductive Health
