Adaptation and validation of social accountability measures in the context of contraceptive services in Ghana and Tanzan
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(2020) 19:183
RESEARCH
Open Access
Adaptation and validation of social accountability measures in the context of contraceptive services in Ghana and Tanzania Victoria Boydell1* , Petrus S. Steyn2, Joanna Paula Cordero2, Ndema Habib2, My Huong Nguyen2, Dela Nai3 and Donat Shamba4
Abstract Background: Changes in the values, attitudes, and interactions of both service users and health care providers are central to social accountability processes in reproductive health. However, there is little consensus on how best to measure these latent changes. This paper reports on the adaptation and validation of measures that capture these changes in Tanzania and Ghana. Methods: The CaPSAI theory of change determined the dimensions of the measure, and we adapted existing items for the survey items. Trained data collectors used a survey to collect data from 752 women in Tanzania and 750 women in Ghana attending contraceptive services. We used reliability analysis, exploratory, and confirmatory factor analysis to assess the validity and reliability of these measures in each country. Results: The measure has high construct validity and reliability in both countries. We identified several subscales in both countries, 10 subscales in Tanzania, and 11 subscales in Ghana. Many of the domains and items were shared across both settings. Conclusion: The study suggests that the multi-dimensional scales have high construct validity and reliability in both countries. Though there were differences in the two country contexts and in items and scales, there was convergence in the analysis that suggests that this measure may be relevant in different settings and should be validated in new settings. Trial registration: ACTRN12619000378123. Keywords: Social accountability, Measurement, Contraception, Tanzania, Ghana
Background Considerable progress has been made in increasing women’s access to modern contraception [35]. Nevertheless, there is continuing unmet need, particularly for those with less education, lower incomes, and younger age, and high rates of discontinuation due to poor * Correspondence: [email protected] 1 Global Health Institute, Geneva Graduate Institute, Geneva, Switzerland Full list of author information is available at the end of the article
quality of care and negative patient experience [10, 35, 39]. In recent years, there have been renewed efforts to understand better and address issues surrounding the quality of care and clients’ experiences of contraceptive services. Studies have identified a range of quality care issues that negatively affect clients’ experiences of interacting with contraceptive services [3, 17, 25]. Community engagement and more patient-centred care have come to the forefront as essential mechanisms
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the sourc
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