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Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews. | LitMetric

AI Article Synopsis

  • - The study aimed to investigate how the location of exit interviews (facility vs. home) affects clients' perceptions and satisfaction with family planning services in Pakistan, as there is little evidence on this issue to date.
  • - A survey conducted from December 2015 to January 2016 with 2,807 clients revealed that exit interviews at facilities often led to more positive responses, indicating potential bias based on interview context.
  • - The findings suggest that home-based interviews may yield more honest feedback, particularly for clients of NGO clinics and social franchise centers, while outreach settings had clients more willing to share negative experiences.

Article Abstract

Purpose: Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews.

Methods: A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake.

Results: Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality).

Conclusion: Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937485PMC
http://dx.doi.org/10.2147/OAJC.S153443DOI Listing

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