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Pages 442-462

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From page 442... ... 430 Potential Transactional Barriers to Contraceptive Use For the analysis of transactions and their implications for client behavior and satisfaction, the framework used here takes a parallel view of the client's social setting and of the provider's delivery system and social setting. Potential barriers to the quantity and quality of client-provider transactions have been delineated, and Organized along three dimensions: (1) Read the entire page →
From page 443... ... 431 TABLE 2 Potential Barriers to the Quantity and Quality of Client- Provider Transactions Barriers in the Larger Delivery System Program budget is inadequate. Providers' salaries are inadequate. Read the entire page →
From page 444... ... 432 REFERENCES Ainsworth, M Read the entire page →
From page 445... ... 433 Leventhal, H., and P.D. Cleary (1980) Read the entire page →
From page 446... ... 434 Seaton, B Read the entire page →
From page 447... ... 18 Client-Provider Transactions in Family Planning Clinics Diane Beeson, Helene L Lipton, Donald H Read the entire page →
From page 448... ... 436 advantage did not exist, of course, when certain times were set aside exclusively for family planning. On the other hand, demands on a provider's time tend to be greatest in what have been described as horizontally integrated health ser- vices; such services seek to tackle health problems on a wide front and on a long-term basis through the creation of general health ser- vices, with an emphasis on primary care. Read the entire page →
From page 449... ... 437 private service is feasible where there is a significant private medi- cal network (Freedman et al., 1969) Read the entire page →
From page 450... ... 438 already practiced birth control and are seeking a new method; the others have demonstrated the strength of their motivation by bringing themselves to the clinic. He adds as follows: It is not surprising that virtually all of them have heard of the pill or the IUD and know that conception results from the union of the sperm and the egg. Read the entire page →
From page 451... ... 439 and other health care needs, without the expanded use of nonphysi- cians. In an effort to clarify the elements of effective clinic-based family planning programs, the discussion below examines the evidence on how both physicians and other providers function in programs and transactions. Read the entire page →
From page 452... ... 440 It should be noted that the success of this program is dependent on very strong organizational support and supervision, which most gov- ernment programs lack (see Chapter 10) Read the entire page →
From page 453... ... 441 The women were asked by whom they would like to be seen when visiting the family planning service. Of those who had been seen by the pasante, almost half said they would prefer to be seen by an auxiliary nurse. Read the entire page →
From page 454... ... 442 staff, depending on the socioeconomic status of "simulated" experimen- tal clients. They tended to recommend only the IUD for low caste, un- educated couples, for example, despite the availability of orals, condoms, injections, and sterilization, regardless of whether the couple wished to space or terminate their childbearing. Read the entire page →
From page 455... ... 443 may be better indicators of the adequacy of communication and the in- ternalization of the message communicated. A number of factors affect both acceptance and continuation rates. Read the entire page →
From page 456... ... 444 locations were selected for a prospective study. The investigators concluded as follows (Stephens, 1978:16) Read the entire page →
From page 457... ... 445 Focusing more directly on commodity costs, Lewis (1984) has re- viewed the available data on cost recovery experience in family plan- ning programs, and on the sensitivity of consumer demand to changes and differences in contraceptive prices. Read the entire page →
From page 458... ... 446 Limited Client-Provider Transaction Time The limited time available for client-provider transactions in busy clinics proves to be a serious barrier to the adoption of effective contraceptive methods by clients. Read the entire page →
From page 459... ... 447 physicians may be deferential, but are more noncompliant than patients of nonauthoritarian physicians. Determining whether or not this is the case in other cultures and settings would require further study. Read the entire page →
From page 460... ... 448 having failed for the second time to ask about possible side effects, explained "We did not ask whether the loop might have harmful effects because they had already told us that the loop would be best for us" (Schuler et al., 1985:263) Read the entire page →
From page 461... ... 449 women preferred to buy them at the pharmacies. She quotes one woman (p. Read the entire page →
From page 462... ... 450 disaffected users can sabotage an entire program by starting, spread ing, or confirming rumors about the dangers of participation. These rumors may be allegations about specific methods and side effects, such as pills causing cancer or accumulating in the uterus, IUDs damaging the penis during intercourse, or sterilizations creating impotence. Read the entire page →

From page 442...

... 430 Potential Transactional Barriers to Contraceptive Use For the analysis of transactions and their implications for client behavior and satisfaction, the framework used here takes a parallel view of the client's social setting and of the provider's delivery system and social setting. Potential barriers to the quantity and quality of client-provider transactions have been delineated, and Organized along three dimensions: (1)