Too often, studies show that clients do not make adequate use of facilities offering family planning (FP) and other reproductive health (RH) care services. To compound these missed opportunities, many health centers fail to reach or attract potential FP/RH clients. Shortages of supplies and a lack of skilled staff at some facilities contribute to the frustrations faced by clients and community members. But disappointment and lack of engagement also occur at service delivery sites with adequate supplies and trained providers who adhere to up-to-date standards for FP/RH services. Experience indicates that many primary providers struggle with the concept of quality of care, finding it too abstract and difficult to implement. Moreover, a consideration of the client perspective is often missing: Many providers have never treated their FP/RH clients as customers whose needs should be understood and met in their daily practice.

Research indicates that clients do “vote with their feet,” and make choices about services, and that these choices are influenced by client perceptions of service quality and accessibility. Data from various FP/RH projects that have incorporated consumer input and community involvement suggest that significant increases in use of services can occur when providers are more customer-focused in the way they deliver services and where provider-community dialogues are an intentional component of health care system design and implementation.

PRIME II played a leadership role in Integrating Consumer Perspectives (ICP) into FP/RH service delivery, shifting the paradigm from provider-oriented services to an emphasis on provider-consumer partnerships. This prototype is based on the assumption that higher levels of service quality and provider performance cannot be achieved without a clear understanding of client needs and expectations, along with the incorporation of those needs and expectations into the daily activities of providers.

As part of the Project’s efforts to promote ICP, PRIME co-chaired the Maximizing Access and Quality initiative subcommittee on Community-Driven Quality, which facilitated a collaborative effort to identify, test and disseminate tools that strengthen provider-client partnerships to define and improve quality of services. Presentations, tools and other resources presented at a day-long forum on Community-Driven Quality in January 2003 are available on the MAQ CDQ-Day CD-ROM.