| [Background]Correlative laws and statutes must be followed when the technique and services of family planning are engaged. Institutions and personnel of family planning must enforce unitive standards and criterions. It is a precondition to ensure using contraception methods safely and availably that technique criterions should to be established and renovated in time. With the incessant updating of family planning technique standards and criterions and thorough development of informed choice about contraception and knight service, the population and family planning task has already got a brilliant achievement. However, macro index of control population is the attention point of family planning while the service qualities are ignored in a certain period and extent. And some conception controls are not standardizations.[Objectives]To describe the probation of the technique standards drawn out in the study and used in experimental units. To explore the executive process, impact and applicability of the technique standards.[Methods]This is an effect evaluation study. The Strategic Approach framework developed by WHO/RHR and the Performance Improvement framework developed by Human Performance Technology were used. Quantitative and qualitative methods were adopted in the fieldwork. Each of the study sites includes one county and one township in Chongqing Municipality, Ningxia Hui Nationality Autonomous Region and Henan province.The main application approaches included applying the established technique standards, and using the unitive family planning OPS medical records, training administrative personnel and service providers, supervising and assessing. After one year, the service facilities, procedures were observed on the spot. The family planning administrative staff, service providers and some clients exited from service were interviewed by research staff. Some women at reproductive age at study sites were investigated with a structured questionnaire. The different family planning service status before and after the intervention were compared. [Results]1. Service Provider:Family planning service procedures were improved, particularly enhancing the provision of the greeting, the history enquiring, the preoperative test, operations procedures, modeling the counseling and procedure of follow up.Service providers' relevant medical knowledge were advanced obviously. Their score of speciality exams raised from 39.03 to 79.30. Single information increased respectively too. The integrity rate of case history was high, the writing was canonical and clear. The quality of medical records in the application group was better than that of control group.As an emphasis, the study applied counseling ascensively and edited a colorful handbook called "conception methods' counseling guidance", which could be used both by the provider and client when counseling went along. The result of face-toface counseling was good.2. Service client:Clients' satisfaction and good estimate to the service quality were increased after application. Data on the baseline investigation indicated that 57.7% women satisfied with the service they received and their currently used contraceptives, 28.8% women gave good estimate to the service quality. However, after application, these proportions were increased to 71.5% and 56.7%. Multivariate Logistic Regression analyses indicated that the clients' satisfaction (Adjusted OR=1.74, 95%CI=1.22～2.50), and estimate to the service quality (Adjusted OR=4.04, 95%CI=2.91～5.60), were significantly increased after intervention. Moreover, the satisfaction on the service and the current contraceptives was affected by the coherence between clients' current contraceptives and their willing, and the quality of the service. Clients' estimate to the service quality was affected by the regions, educational level, inhabitancy, operation procedures and whether hearing of informed choice and knight service or not.The Kappa value of the coherence between clients' current contraceptives and their willing was 0.625. There was no significantly difference in the coherence after intervention, compared with that before intervention. The coherence was affected by the price of the current contraceptives and whether knowing the rights of contraceptive informed choice.[Conclusions]The application measures in this study can significantly improve service provider's level of relevant medical knowledge and operation. Clients' estimate to the service quality and satisfaction was better. The application approaches may be expanded in less developed areas of China.
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