Using self-assessment to improve the quality of family planning clinic services.

A follow-up study was conducted to evaluate the effect of a self-assessment technique called COPE (client-oriented, provider-efficient) on the quality of family planning clinic operations in Africa. In 1991 the Association for Voluntary Surgical Contraception revisited 11 clinics where it had introduced COPE from five to 15 months earlier. Changes that had occurred as a result of the COPE intervention were assessed by (1) determining how many of the clinic problems identified by staff at the COPE introduction had been solved; (2) comparing the results of a second client-flow analysis with the initial analysis; and (3) interviewing service providers to obtain their opinions of the effects of COPE. Of the problems identified by staff nearly three-fourths of those that could be solved internally were solved. The study revealed improvements in the quality of care provided as well as increased staff involvement in solving clinic problems.