Assessment of Contraceptive Counseling Service Quality Gap Using Service Quality Model at Public Health Centers in Addis Ababa, Ethiopia 2025: Clients Perspective
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Date
2025-06
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Addis Ababa University
Abstract
Background:
For women to make informed decision about their sexual and reproductive health, quality contraceptive counseling is essential. The provision of equitable and quality health services to the population is one of the strategic directions of the second Health Sector Transformation Plan (HSTP-II) of Ethiopia with due emphasis on Family planning, reproductive and maternal health services. To improve quality effectively, it's important to first identify where the gaps are in terms of quality dimension, but there is limited study that assess contraceptive counseling service quality from the clients’ perspective in terms of client’s expectation and perception of the counseling service.
Objective: To assess the service quality gap between expectations and perception of clients for contraceptive counseling service and to identify associated socio-demographic characteristics at Public Health Centers in Addis Ababa, Ethiopia.
Methods: A facility-based cross-sectional study design was conducted using structured service quality tool among 279 participants from March 15 - April 26, 2025. Data was cleaned in excel and then exported to SPSS 25.0 for analysis. Descriptive statistics, Wilcoxon sign-rank test and Kruskal-Wallis test were used to compare the median score values of expectations and perception of each service quality dimension and across demographic groups respectively.
Result: 279 clients were agreed and participated in this study with response rate 97.89%. The overall service quality gap in contraceptive counseling service described by the median and Interquartile range is -2.23 (-2.7 to 1.7). The median score for expectation and perception is 4.27(3.86 to 4.55) and 1.98 (1.73 to 2.34), respectively. Age group >31-40, new service user and client who have college degree and above showed statistically significant higher expectation in one or more dimensions of the SERVQUAL.
Conclusions: Across all SERVQUAL dimensions, clients perceived quality of counseling services at public health centers was lower than expected, with the biggest discrepancies found in assurance and responsiveness dimensions. Therefore the finding point to the necessity of increased staff competency, clear communication, and timely attention to clients' emotional and psychological needs.
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Keywords
Service quality, contraceptive counseling, family planning, expectation, perception