The Role of Quality of Care in the Demand for Family Planning Services in Tanzania

262 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2001.The low contraceptive prevalence rate and the existence of unmet demand for family planning services in Tanzania presents a challenge for parties involved in family planning research. The observed situation has been explained by the demand side variables such as socio-economic characteristics and cultural values that maintain the demand for large families. However, little empirical research has been done on the effect of supply side factors such as quality of care of family planning services on the demand for contraceptives. This research determines the providers and clients' perceptions of quality of care of family planning services and the impact of demand and supply side factors on contraceptive use and facility choice. Quality of care variables were created using quantitative data obtained by merging the Tanzania Service Accessibility Survey (1996) and Tanzania Demographic and Health Survey (1996) data files. These indices were compared with the data obtained from women using focus group discussions. The regression analysis results show that women's total years of schooling and availability of piped water have positive and significant impacts on contraceptive use for urban women. Literacy, husband's total years of schooling, total number of children, possession of a house with a good floor, exposure to mass media, and dummy variables representing religious affiliation have positive impacts on contraceptive use for both urban and rural women. Of the supply side factors, mechanisms to encourage continuity and the constellation of services have positive and significant impacts on contraceptive use and facility choice for urban women, whereas information given to clients and technical competence showed positive impacts for both urban and rural women. Distance to the nearest health facility showed a negative impact on contraceptive use. The choice of methods and information given to clients showed positive impacts on the probability that a facility is chosen by urban and rural women. Increased wealth of the households resulted in increased probability of utilizing more endowed facilities like hospitals. Decreasing the travel cost to the nearest health facility resulted in a greater access for women from poor households compared to women from rich households.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD