Alfred Agwanda and Anne Khasakhala and Maureen Kimani and Macro International Inc. Calverton, Maryland, USA

This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. Data was obtained from the 2004 Kenya Service Provision Assessment. The composite indicators scores for facility readiness were generally low and many facilities lacked simple items like visual aids, guidelines, towels, speculum, etc. There were marked differences in facility readiness by region, facility type, and managing authority. Provider service provision scores were generally high but the only important difference was by region. Client satisfaction was dependent on the facility type, managing authority, sex of the provider, and the waiting time to receive services. Clients were more likely to be satisfied with female rather than male providers. Clients were less satisfied in Nyanza, although the facilities were more ready with high-performing providers. In contrast, North Eastern Province had less ready facilities, but high client satisfaction and high provider performance. Health centre, clinics, and dispensaries need to be revamped to appropriate standards so as to include all basic elements of family planning service provision. North Eastern Province, with motivated workers, highly satisfied clients but poor facilities, deserves proper attention. Facilities in Nairobi need improvements in staff supervision and retraining. There is need to educate the clientele on the availability of appropriate services within the government facilities.