Background. Despite good contraceptive coverage rates, recent studies in Iran have shown an alarmingly high incidence of
unplanned pregnancy.
Objective. To determine factors affecting quality of family planning services, a cross-sectional study was performed from
June to August 2006 on women visiting urban Primary Health Care clinics in a provincial capital in western Iran. The
primary focus of the study was on provider–client interaction.
Method. We used a slightly edited version of a UNICEF checklist and a convenient sampling method to assess quality of
care in 396 visits to the family planning sections at 25 delivery points.
Results. Poor performance was observed notably in Counselling and Choice of method sections. In logistic regression analysis,
the following factors were found to be associated with higher quality of care: provider experience [OR (odds ratio) ¼ 1.9,
CI0.95 (confidence interval) ¼ 1.2 –3.0], low provider education (OR ¼ 6.7, CI0.95 ¼ 4.0–10.8), smaller workload at the clinic
(OR ¼ 3.7, CI0.95 ¼ 2.0–6.7), and ‘new client’ status (OR ¼ 4.2, CI0.95 ¼ 2.6 –6.7).
Conclusion. This study identified the issues of counselling and information exchange as the quality domains in serious need
of improvement; these areas are expected to be the focus of future training programmes for care providers. Also, priority
should be given to devising effective supervision mechanisms and on-the-job training of senior nursing and midwifery graduates
to make them more competent in delivering basic family planning services.