Perceived quality of care and contraceptive use among social marketed and commercial health establishment clientele in urban Pakistan.
The objective was to examine predictors of perceived quality of care and contraceptive use and to provide more information on the influence of social marketing programs on quality of care and contraceptive use by comparing Greenstar social marketing outlets with other commercial health establishments. This study is based on an urban exit survey of 5,321 clients conducted in May and June 2001. Quality of care was measured in terms of features clients liked at the health establishments they visited. Predictors of contraceptive use include indicators of quality of care, social environment, exposure to channels of communication, exposure to Greenstar information, and background characteristics. Analysis involved descriptive statistics and logistic regression. Of the clients interviewed, 5 1 percent were male; 89 percent were at least 25 years old; 93 percent had at least one child; and 72 percent had some schooling. The results show that perceived quality of care varied according to sex, years of schooling, and how often clients listened to the radio or watched TV. Significant predictors of contraceptive use were years of schooling, number of children, how often a client listened to the radio or watched TV, awareness of the Greenstar logo and what it represented, and perceived quality of care--closeness of the health establishment to home or work, affordable fees, availability of a doctor at the outlet, and knowledgeability of the provider. Results suggest that social marketing programs have an impact on both quality of care and creating a demand for contraceptives. Program interventions that increase the perceived quality of care at a health establishment may attract more family planning clients and increase contraceptive use among couples in Pakistan. (author's)