Quality Upheld: Every Service, Every Time
The reproductive health of women and girls—particularly their ability to access modern contraception—is a critical factor for improving their lives and overall well-being. Preventing unintended pregnancies reduces maternal and infant deaths, decreases unsafe abortions, and allows many adolescent girls to continue their education. Access to and use of contraception also gives women control over their sexuality and reproduction, which results in a healthy, productive life.
Aynalem has worked at the Afriflora Sher Farms for eight years. In addition to supervising the cleaning of Greenhouse #30, she works with the farm’s safety committee to ensure the welfare of staff. She is also a volunteer peer educator with Marie Stopes International Ethiopia’s “Fit-For-Work” project, with one hour each work day dedicated to informal counseling of other employees on family planning use and methods.
The most dynamic young women in Lucknow, India belong to a special club. They call themselves Mehak, meaning fragrance. Membership has just one requirement: a passion for improving the status of women and girls in the community. The group is part support group, part health counseling session and part leadership development and mentorship program. Mehak was formed two years ago with support from PAI partner, SAHAYOG, and is facilitated by Shabnam Sheikh—an accredited social health activist, or ASHA—whose two daughters are also members.
A vast, diverse and populous country, the Democratic Republic of the Congo (DRC) faces many development challenges. With maternal and infant mortality rates among the highest in the world, combined with high fertility rates, a rapidly growing population and low contraceptive use, reproductive health is arguably one of the country’s most pressing and complex issues.
Inequitable and harmful gender norms and practices are among the most critical factors that prevent women from accessing high-quality health care and family planning services. In each QUEST country, actions to counter the patriarchal structures that underpin constraints on women’s autonomy and mobility are insufficient—especially in the context of reproductive health policy and service delivery.
Values and Community Norms
Many dynamics that define quality, including the political and legal context, are at play before a woman seeks care at a clinic. PAI and partners have found that the delivery of quality health services in many QUEST countries is affected by both the past and current political ideology as well as governance at the federal level. Importantly, the influence of former policies often remains strong even after new progressive laws and policies are developed to promote quality and protect rights.
Providing quality reproductive health care services that honor women’s rights requires a health system underpinned by a strategic vision. Strategies must be carried out through an efficient management system that plans and budgets based on the needs of the population it serves. Country assessments have revealed various management issues in the QUEST geographies, including challenges with planning, budgeting, ethics, participation and accountability.
Health System Strength and Management
Our country findings indicate that the interplay of socio-cultural norms, as well as gender discriminatory attitudes and practices, are of concern for ensuring the reproductive rights of young people, particularly unmarried youth. The majority of QUEST geographies have a dedicated national sexual and reproductive health policy for youth or include its components as part of a larger youth policy.