A structural approach to the evaluation of the quality of contraception services

A quality assessment of contraceptive service in Belgrade Yugoslavia in 1983 was conducted using a structural approach (investigation of the knowledge and attitudes of service providers and the availability of contraceptives). Summaries of cited publications were used as the standard of knowledge and attitudes. A sample of 42 gynecologists (16.6% of the total Belgrade population of gynecologists) was investigated using a mailed questionnaire. Compared with the chosen standard: 2 fields of knowledge about combined oral contraceptives (OCs) appeared unknown to about 70% of the sample (OC protective effects and effects of previous OC use on the outcome of subsequent pregnancy); knowledge of the IUD as a risk factor in pelvic inflammatory disease is lacking in 33.3% of the sample; and attitudes regarding other contraceptive methods are in accord in about 60% of the investigated sample. Furthermore the unavailability of contraceptives is recorded. Methodological shortcomings and a possible positive result of the study are discussed. (authors modified)