Objective: To identify bottlenecks in the delivery of comprehensive family planning to women in contact with the Health Services and to find ways to reduce unmet demand for contraception.
Design: Exploratory descriptive study.
Setting: Large Bulawayo Government Hospital and the high density areas in the same city.
Subjects: Case notes of 284 women who indicated together with their partners that they had completed families and who had their tubal ligation forms duly signed but who never had their operation. Follow up of a sample of patients.
Interventions: Non intervention study.
Main outcome measures: Are reproductive rights taken seriously? Is there service related unmet demand for family planning.
Results: Even those who had all their paperwork in order for a durante or post partum sterilization did not have any guarantee that this service would be given. The main reason was found to be lack of well motivated health staff.
Conclusion: Much can be improved in contraceptive service delivery. Reproductive rights are not respected.
PIP: Family planning staff in a Bulawayo hospital were interviewed during June 1994 in order to identify bottlenecks in providing good contraceptive service. A file was produced by the family planning nurses [corrected] with 284 used tubal ligation (TL) forms covering the period September 1989-June 1994. Although each form was signed ante natally before labour [corrected] by the woman, [corrected] her partner or guardian, two witnesses, a junior doctor, a consultant in obstetric and gynecology, and the superintendent or his deputy, the TLs never took place. One woman had filled out a form twice with 3 years in between. The women were on average 35.5 years and had on average 6.6 children at the time the TO was supposed to happen. [sentence added] Case notes on these women were analyzed. Additionally, 34 of the women who had [corrected] sought postpartum sterilization or during caesarean section [corrected] were contacted and interviewed. The case notes and the [corrected] women gave a wide range of reasons why [corrected] they were not sterilized: delivered vaginally on a Friday, given preoperative breakfast by accident, doctors on strike, consent forms lost, doctors forgot, other operations having priority [corrected]. The main reason, however, why these women did not receive a[[corrected] TL is because the attending health personnel were poorly motivated. There is clearly much which can be done to improve the delivery of family planning services at the hospital.