ORIGINAL RESEARCH article
Front. Reprod. Health
Sec. Access and Barriers to Reproductive Health Services
Volume 7 - 2025 | doi: 10.3389/frph.2025.1558606
Exploring client satisfaction and determinants of family planning services at public health facilities in Debre Tabor town, Northwest Ethiopia: A mixed-method study
Provisionally accepted- 1School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- 2Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Amhara Region, Ethiopia
- 3Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Amhara Region, Ethiopia
- 4Institute of Public Health, University of Gondar, Gondar, Amhara Region, Ethiopia
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Introduction: Client satisfaction is a crucial indicator of family planning service utilization, and understanding these insights is essential for designing responsive, client-centered interventions to address barriers to contraceptive use. This study aimed to explore client satisfaction and determinants of family planning services in public health facilities in Debre Tabor town, northwest Ethiopia. Methods: A convergent parallel mixed-methods design, incorporating both quantitative (facilitybased cross-sectional) and qualitative (phenomenological) study approaches, was conducted at public health facilities in Debre Tabor town from April 15 to May 29, 2024. Data were collected using an interviewer-administered questionnaire following a multi-stage stratified random sampling technique. Simultaneously, qualitative data were collected from purposefully selected individuals using an in-depth interview guide. The study used EpiData version 4.6 for data input and SPSS version 25 for logistic regression analysis, using a p-value < 0.05 as the cutoff point.After an in-depth interview, the record and field notes were transcribed, translated, and analyzed using a thematic analysis technique.Result: Out of 379 participants, 62.5% of clients were satisfied with the family planning services. Factors significantly associated with clients' satisfaction were urban residents (AOR=1.68, p=0.022), government employees (AOR=0.40, p=0.020), shorter waiting times (AOR=2.93, p=0.039), method counseling (AOR=2.32, p=0.005), and receiving the preferred method (AOR=2.59, p=0.024). From the in-depth interview of 15 participants, two themes emerged: -limited provider-client counseling interaction,‖ with subthemes of -cultural sensitivity gaps,‖ -misconceptions,‖ and -fear of ineffectiveness,‖ and -pathways to satisfaction,‖ with subthemes of -dignified care‖ and -accessibility.‖The study found moderate client satisfaction with family planning services in public health facilities, with significant disparities in residence, occupation, waiting time, method counseling, and preferred methods. Clients reported a lack of cultural sensitivity, misconceptions, and a lack of involvement in decision-making. To improve satisfaction, health facilities should strengthen client-centered counseling, address cultural misconceptions, and provide flexible service hours and training for providers.
Keywords: Client satisfaction, determinants, Family planning service, mixed-method study, Northwest Ethiopia
Received: 10 Jan 2025; Accepted: 01 Aug 2025.
Copyright: © 2025 Asefa, Tesfaye, Bitew and Endale. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tseganesh Asefa, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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