Background: Despite a large body of literature citing the benefits of community-based distribution of family planning (FP) services and high-quality FP services, there is a lack of studies measuring the quality of community-based FP services. Objectives: 1. Evaluate how client perspectives on quality differ from those of health professionals; 2. Identify factors that influence client recall of contraceptive counseling; and 3. Develop a metric for measuring quality and test the association between client satisfaction and quality. Methods: This study employed a convenience sample of 1,179 women ages 15-49 years old who sought contraceptive services from community-based FP distribution events in Kinshasa, DRC. Data were collected using three different instruments: CEIs, COs and provider interviews. Methodology: Paper 1. The 28 variables measured by both the CEI and CO were compared using Gwet’s Agreement Coefficient. Paper 2. The association between recall and provider and client characteristics were tested using multivariate linear regression. Paper 3. Exploratory factor analysis was performed and resulting factor scores were used to test the association between quality and client satisfaction in multivariate linear regression models. Results: Paper 1. According to Gwet’s AC1, COs and CEIs were in agreement for 18 of the 28 items, with most discordant variables falling in the “effective use of the chosen method” domain. Paper 2. Average recall score was 67.6%. Time since the provider’s initial training and quality of the client-provider interaction were associated with higher client recall. Being a first-time user was associated with lower recall. Paper 3. All three domains of quality were significantly associated with client satisfaction after controlling for client characteristics and interactions. Conclusion: This is one of the first studies to measure the quality of individual contraceptive counseling sessions during community-based distribution events. Findings have resulted in several recommendations to improve client recall and satisfaction during these events.
