One-Year Impacts of a Quality-of-Care Intervention on Contraceptive Use and Reproductive Goal Attainment

Federico R. León, Independent Consultant
Alex Ríos, Independent Consultant
Adriana Zumarán, Independent Consultant
Santiago Roca, Escuela de Administración de Negocios para Graduados (ESAN)
Ana R. Feijoo, Escuela de Administración de Negocios para Graduados (ESAN)

This randomized study tested whether significant improvements of the quality of care, achieved earlier by introducing the Balanced Counseling Strategy at Peru Ministry of Health clinics, are followed by improved long-term outcomes. 24 health directorates were the study units; 12 of them received the intervention. New-event family planning clients were recruited as they exited counseling sessions and interviewed with the calendar module of the DHS to tap their subsequent 12-month contraceptive history (N = 215). Mean monthly contraceptive use rates per health directorate were calculated for each cohort. The treated cohort showed greater use (.81 versus .78, p < .01) when contemporaneous perceptions of need were considered as well as greater attainment of contemporaneous reproductive goals (.96 versus .95, p < .01). Better impacts were achieved at smaller health networks. The results are modest but important because the Balanced Counseling Strategy can be substantially improved.