Assessment of family planning sterilization services at public health institutions in Maharashtra before and after intervention

Background: Family planning services have been given importance for decades. For various reasons, sterilization has been the first choice of women and the government. It is feared that while achieving large numbers, the quality may be compromised. There were Public Interest Litigations in Supreme Court about the compromised quality of sterilization services. Objectives: The aim of this study was to compare the quality of sterilization services before and after interventions and the quality between types of institutions. Materials and Methods: This study was carried out in two phases. The first phase included visits to 33 institutions from 13 districts on sterilization operation days. The observed lacunae were communicated to the government, and accordingly, some interventions were executed by the government. In the second phase, we visited 13 institutions from five districts. The investigators were from the Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, India. We used assessment tools based on the Government of India’s guidelines. One device was developed to assess the quality of services, and marks were given by dichotomizing the observations. In both phases, the same tool was used. The maximum score was 140. Results: In the first phase, an institution’s mean score was 94.15 (±7.58). There was no difference between the types of institutions. In the second phase, the mean score improved to 103.27 (±13.29) (t = 2.94; P = 0.01); the hospital score improved from 91.00 to 109.83 (t = 4.94; P = 0.001). Conclusion: The findings of this unique multisite study indicate that interventions indeed led to improvements in both primary health centers and hospitals, but the extent of improvement was more significant in hospitals.