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Obstacles to Quality of Care in Family Planning and Reproductive Health Services in Tanzania

Issues of quality of care have become central in debates about family planning and provision of reproductive health services. These debates are a response to inequalities that have not historically been captured in service delivery studies. Discussions concerning quality of care, and my arguments in this paper are an attempt to address crucial health care issues that lie behind the numbers of condoms distributed and sterilizations performed such as how well family planning programs serve the needs of clients, both technically and interpersonally. The analysis of quality of care in this paper relies on the definition provided by Hardon and Hayes (1997) in their expanded version of the commonly accepted Bruce (1990) framework. This framework hypothesizes that quality of care is composed of the following seven elements: choice of methods, information given to clients, technical competence, client-provider interpersonal relations, mechanisms to encourage continuity, appropriate constellation of services, and avoidance of incentives and disincentives.