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Quality Assurance of Family Planning Services in Rural Pakistan: Suraj Social Franchise Model

This study evaluates the quality assurance (QA) framework of family planning services under the Suraj social franchise model in rural Pakistan. The project involved 126 providers spread across Punjab, Sindh, and KPK, focusing on recruitment, training, and monitoring client experiences. Data collected from various QA indicators revealed a high overall score of 85%, with an exceptional client satisfaction rate of 99.9%. The findings indicate a need for continuous QA improvements and training to sustain high service quality and community trust in the Suraj clinics.

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Quality Assurance of Family Planning Services in Rural Pakistan: Suraj Social Franchise Model

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  1. Quality Assurance of Family Planning Services in Rural Pakistan under the Suraj Social Franchise model Authors: Xaher Gul, Komal Daredia, Saeed Qureshi, Asma Balal, Shahida Naqvi

  2. Background Information MSS Service Delivery Network 126 Providers 72 Punjab 12 Sindh 42 KPK Field Worker

  3. Framework for Quality Assurance in SF Recruitment Feedback Training Monitoring of Client Experience Monitoring of Clinical & Non Clinical quality Source: The Basics of Quality Assurance in Social Franchising, Quality Assurance Framework Summary, UCSF Global Health Sciences, The Global Health Group

  4. Background Information Selection Criteria for Suraj (Sun) Providers Good Reputation in community Private Qualified Providers Experienced in RH Service Delivery Open to periodical audits and QA visits Located in non urban, low income area Willing to abide by Suraj TOR’s Willing to maintain Suraj Records Adequate Infrastructure Accessible and willing for training

  5. Background Information Structure for QA visits • MSI QTA • Client Exit Interview (Third Party) Annually Project Office Annually Quarterly Region Office

  6. Methodology 367 Indicators Quality Assurance Scan Indicators • Knowledge Assessment • (15 Indicators) • Infection Prevention • (38 Indicators) • Supplies • (24 Indicators) • Emergency Preparedness • (67 Indicators) • Counseling • (64 Indicators) • Procedure Competency under Observation(115 Indicators) • Clinical Administration • (44 Indicators) Source: MSS QA scan is adopted from MSI QTA Check list and modified from WHO FP Standards.

  7. Methodology Overall Score 85% & > 85 % < 50% 50% to 70% 70% - 84% Weak / Non Compliant Excellent Average Good Training Need Assessment Red Flag Issue Non Compliance Issue

  8. Findings (Dec 12 – Jun 14) Perceived Quality 1/5of all RHF clients cite provider reputation as the main reason for choosing SURAJ clinics for FP services. 99.9% - visit the facility again in the future. 99.9% - willing to recommend the health facility to others. 99.9% clients expectation met or even exceeding Waiting Time 15minutes 100% - clients satisfied

  9. Findings (Dec 12 – Jun 14) Average internal QA scores of Suraj Clinics 99.25 Average QTA* Score [8 Providers randomly selected, December 2013] *Marie Stopes International conducts QTA assessment on an yearly basis

  10. Way forward Electronic QA Scans with Touch Tablets

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