Abstract:
The development of guidelines to improve the quality of CTOP services in public health
facilities remains very important in ensuring the continuous provision of quality CTOP
services. The assessment of the quality of CTOP services in public health facilities has
been seriously neglected. The objectives of the study were to assess, determine and
evaluate the quality of CTOP services in public health facilities using the Donabedian
model of quality care. The purpose of the study was to develop guidelines to improve
the quality of CTOP services in public health facilities.
A quantitative, non-experimental, cross-sectional survey research design was used to
achieve the objectives of the study. The study was conducted in two phases. During the
first phase, the objectives of the study were to assess, determine and evaluate the
quality of CTOP services in public health facilities using the Donabedian model of
quality care. Quantitative data was collected from 104 participants comprising of facility
and quality managers, registered professional nurses and midwives and the post-CTOP
clients from the eight public health facilities involved in the study. Questionnaires were
used to collect data. The findings confirmed the challenges experienced by healthcare
professionals and clients in the CTOP clinics. The study revealed the inadequate
infrastructural challenges, lack of ablution facilities, lack of rest rooms for clients post
termination of pregnancy, lack of privacy, overcrowding of clients, clients not honoring
follow up dates, lack of proper referral routes and repeat CTOP requests. In the second phase, guidelines to improve the quality of CTOP services in public health
facilities were developed based on the findings of phase one. Modified Delphi technique
method was used to develop and refine the guidelines to improve the quality of CTOP
services in public health facilities. Three rounds were used to finalize the guidelines by a
panel of six experts involved in CTOP and reproductive health services. Further
research using other models of quality care is recommended.
