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  • Title: Sterilization regret in the Dominican Republic: looking for quality-of-care issues.
    Author: Loaiza E.
    Journal: Stud Fam Plann; 1995; 26(1):39-48. PubMed ID: 7785067.
    Abstract:
    This report approaches the concept of quality of care by looking at the covariates of sterilization regret in the Dominican Republic according to the results from the 1991 Demographic and Health Survey. The main variables observed are the women's satisfaction with sterilization, their decisionmaking process, sterilization experience, use of family planning, and socioeconomic characteristics. The more detailed measurement and analysis of the outcomes of care point to a need for improvement in the public program effort with regard to sterilization. Substantial proportions of women were sterilized who were younger than 30, who had three or fewer living children, and who had the operation before they had used any other method of contraception. Because a greater proportion of sterilization regret is observed among these groups, women must be enabled to make a free and informed decision about sterilization by means of programs that offer a more balanced choice of methods, as well as better counseling, education, and access to high-quality services. A quality of care study examined the covariates of sterilization regret by analyzing data from the 1991 Demographic and Health Survey for the Dominican Republic. The leading contraceptive method was female sterilization (about 40% of women in union) followed by oral contraceptives (10%). Over time, an increasing number of younger women chose sterilization. In fact, 60% of all sterilized women underwent sterilization when they were younger than 30. Almost 40% of women in union who underwent sterilization when they were younger than 30 had no more than three living children. Sterilization was the first and only contraceptive method that 34% of sterilized women in union had ever used. 56% of them were younger than 30. 44% had fewer than four children. These women were more likely to report regret, dissatisfaction with their decision to undergo sterilization, and to not choose sterilization again than did all respondents (11% vs. 5%). Some variables significantly associated with dissatisfaction and regret were: age; no other modern family planning methods used; reasons for sterilization (recommended by medical/family planning worker and side effects/health concerns); a less than 6 month interval between last birth and sterilization; sterilization was first method used; family size less than four; sterilized at delivery; and sterilization was discussed with husband. These findings suggest a need for the family planning program to provide information about all contraceptive methods and their effective use, quality counseling, and access to high quality services to optimize levels of satisfaction among clients.
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