Ensuring high-quality family planning (FP) services is critical in increasing uptake and sustaining positive health outcomes. DESIP programme focused on improving the quality of FP services through strategies such as supportive supervision, performance review, data quality assurance, and quality of care enhancements.
These interventions aimed to address service delivery challenges, enhance provider capacity, and ensure that clients receive comprehensive and quality FP services. Sustaining improved quality for FP services was a primary objective for DESIP during the implementation period.
DESIP focused on building the capacity of counties and sub-counties on the National FP standards as they will be the key resources in institutionalizing the standards beyond the project life.
They invested in joint support supervision due to its ability to integrate the whole RMNCAH range of activities and thus achieve its goals. Digital technology solutions for improving quality of care, such as HNQIS, were utilized to assess and improve the quality of healthcare services provided in private facilities, while in public facilities, KQMH and National FP standards were utilized
One of the key challenges in FP service provision has been inconsistent quality due to inadequate supervision and mentorship.
Many healthcare workers (HCWs) operate in low-resource settings with minimal support, leading to variations in service delivery and client experience. DESIP collaborated with the National and County/Sub-County Health Management Teams (C/SHMT) across the DESIP focus counties to conduct support supervision for health facilities.
DESIP adopted the MOH standard support supervision checklist and advocated for the addition of social inclusion assessment in the checklist.
Through support supervision, the programme identified learning opportunities, challenges, and solutions to barriers affecting access to quality FP services.
The programme further supported mentorship programs that targeted capacity building for healthcare workers, reinforcing knowledge and adherence to FP guidelines. Additionally, integration of supportive supervision with facility-based Continuous Quality Improvement (CQI) initiatives enhanced accountability and sustainability in service provision.
FP service delivery is often not systematically monitored in many health facilities, making it difficult to track progress and identify gaps. DESIP introduced quarterly performance review meetings where healthcare workers and facility managers analyzed FP service data, discussed challenges, and developed action plans for improvement. These meetings provided a platform for knowledge sharing and best practice exchange, leading to a more responsive and data-driven approach to FP service delivery.
To complement these efforts, DESIP also introduced client exit interviews to assess service satisfaction and areas for improvement. The feedback gathered was incorporated into performance reviews to ensure client-centered service delivery. The programme also promoted peer learning forums where high-performing facilities shared insights and approaches that contributed to better service delivery outcomes
Health facilities experience challenges with incomplete, inaccurate, or delayed reporting, which affects decision-making at both county and national levels. To improve this, DESIP supported data quality audits (DQAs) and on-site mentorship for health workers to enhance their capacity in FP data management. By strengthening facility-level data collection and reporting systems, the programme improved the accuracy and reliability of FP data, ensuring that services are aligned with actual client needs.
DESIP also facilitated the integration of electronic health records (EHRs) and digital reporting tools to streamline data entry and analysis, e.g. SARAMED. Additionally, data utilization training was provided to healthcare workers to enable evidence-based decision-making at the facility level. The programme further collaborated with county health teams to conduct periodic data review meetings to track trends, identify service gaps, and inform strategic interventions
Beyond data and supervision, quality of care remains a top priority in ensuring client-centered FP services. Many women seeking FP services have faced barriers such as long waiting times, provider bias, lack of privacy, and limited counseling on method choices. DESIP emphasized client-centered care, ensuring that providers offer non-judgmental, comprehensive FP counseling tailored to individual needs.
Health facilities were supported in setting up youth-friendly and disability-inclusive FP services, making them more accessible to vulnerable populations. Additionally, the programme facilitated community feedback mechanisms, such as suggestion boxes, QR codes and structured client satisfaction surveys, to ensure continuous improvement in service delivery. DESIP also strengthened post-training follow-up for healthcare workers to reinforce adherence to FP service delivery protocols.
