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  • Title: COPE: helping to improve the quality of family planning services in Africa.
    Author: Lynam P.
    Journal: QA Brief; 1993 Jun; 2(1):7-8. PubMed ID: 12345156.
    Abstract:
    The Association of Voluntary Surgical Contraception (AVSC) had developed a new process for family planning providers to improve the quality of services. The Client Oriented, Provider Efficient, or COPE, process was created in response to problems facing family planning delivery sites throughout sub-Saharan Africa. Frequently, clients are forced to wait for hours, only 1 nurse is placed on duty during the busiest times, in some urban sites family planning facilities are inadequately identified, and several clinics lack private consulting areas. Family planning pamphlets and posters may be locked away while clients in the waiting room sit idly for hours. Developing their own plans of action under the COPE process, local staff members assess their own services by means of a problem identification checklist and a client interview form. First, their goals related to client satisfaction and efficiency are evaluated; then providers are guided in conducting a client flow analysis to identify where clients wait the longest. Applying the COPE process for problem solving requires minimal material resources of some flipchart paper, a few pens, and some photocopied sheets and training of a few hours over 3 days. Facilitators visit sites to guide staff through the COPE process. In Kenya, several organizations initially coached by AVSC are replicating the process in multiple sites. Currently AVSC is planning to deliver seminars for its field staff, regional family planning coordinators, and outside agencies. A manual explaining the COPE process is also under development. Follow-up visits to 11 sites 6-12 months after the introduction of the COPE process indicated that 59% of the problems originally identified had been solved. 76% of the solvable problems were rectified. Clinics achieved decreases in time ranging from 18 to 74 minutes in 5 of the 6 sites where waiting times had been considered excessive.
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