Use of systematic screening to increase the provision of reproductive health services in Bolivia

The study objective was to determine if the use of a checklist that screened for unmet services needs could increase the number of services per visit provided to clients using rural Bolivian health facilities. The study included 3448 clients visiting six service delivery points during the eighteen-week study period. Measurement included changes in services per visit before and after the introduction of the intervention and a comparison of services received at screened and nonscreened visits. In the nine weeks following the introduction of the intervention nine percent more services per client visit were provided than in the nine-week period preceding the intervention (p<.001). Provider compliance was an important constraint. Less than half of visits were screened but screened visits resulted in twenty-five percent more services per visit than non-screened visits (p < .001). To the degree that provider compliance can be secured systematic screening of clients appears to be an effective method for reducing unmet health service needs. The findings of this study replicate those of other studies conducted in Africa Asia and Latin America. The Bolivia Ministry of Health plans to scale-up the intervention. (authors)