Perceptions of Women regarding the Quality of Family Planning Services for Low-Income Urban Areas of Karachi

Background: Family planning (FP) is one of the most important family planning services in Pakistan. The purpose of this study is to comprehensively investigate and understand women's perceptions of family planning service quality in the low-income urban areas of Karachi, Pakistan. This study aims to explore the multifaceted dimensions of FP service quality, including individual experiences, attitudes, and beliefs, through the lens of the Judith Bruce framework. Data was collected using semi-structured interview guides for focus group discussions (FGDs) and in-depth interviews (IDIs). Methods: This is an exploratory qualitative study, 4 focus group discussions and 13 interviews were conducted with married women in the age group of 25-45 years, who were either current users or ever-users of modern contraceptives, living in underserved areas of three Union Councils of Malir Town (Saudabad, Khokhrapar and Kala Board), Karachi. Data were thematically analyzed. Results: Family planning quality of care was defined by participants as the quality of healthcare provider communication and counseling skills (i.e. information exchange), and the outcomes of contraceptive use among women with satisfaction to pave the way for continued use of family planning methods. The data showed that women have limited autonomy in their choice of methods and inadequate information on side effects were identified as reasons for discontinuation. Participants emphasized the importance of respectful interactions with providers and clear explanations about methods. Conclusion: Utilizing Judith Bruce's frameworkusing a qualitative approach provided fundamental insights into perceptions and barriers to the quality of care for family planning. Recognizing which elements are particular to family planning is essential for advancing contraceptive consequences. Specifically, women's autonomy in choice of contraceptive method, and robust healthcare systems can enhance service delivery, strengthen women-provider relationships, and ultimately contribute to improved reproductive health outcomes for individuals and communities. By prevailing the importance of dignified behavior with the community members, enhancing technical skills, and fostering women's satisfaction, healthcare systems can strive towards providing equitable access to high-quality family planning for women.