The field of family planning has been at the forefront of the movement to begin prioritizing quality of health care services as opposed to focusing more narrowly on coverage and utilization. A focus on quality in family planning began most notably with Judith Bruce's 1990 publication of a framework to assess quality from the client's perspective, informed by Avedis Donabedian's foundational definition of health care quality in terms of structure, process and outcome elements [
- Bruce J.
Fundamental elements of the quality of care: a simple framework.
Stud Fam Plann. 1990; 21: 61-91
- Donabedian A.
Evaluating the quality of medical care.
Milbank Mem Fund Q. 1966; 44: 166-206
3]. Bruce's publication came more than a decade before the United States (US) Institute of Medicine's groundbreaking report Crossing the Quality Chasm [
- Donabedian A.
The quality of care: how can it be assessed?.
JAMA. 1988; 260: 1743-1748
] and the World Health Organization's publication of guidance for quality improvement in health systems [
- Institute of Medicine
Crossing the quality chasm: a new health system for the 21st century.
National Academies Press, 2001
], and has informed countless efforts to monitor and improve family planning programs. Its focus on quality from the client's perspective is in line with the now prominent “Triple Aim” framework which includes patient experience as one of three organizing principles of optimal health systems, in addition to cost and population health [
- World Health Organization
Quality of care: a process for making strategic choices in health systems.
- Berwick D.M.
- Nolan T.W.
- Whittington J.
The triple aim: care, health, and cost.
Health Aff. 2008; 27: 759-769
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Published online: June 20, 2017
Accepted: June 11, 2017
Received in revised form: April 20, 2017
Received: September 13, 2016
☆Conflicts of interest: none.
☆☆Funding: This work was supported by the David and Lucile Packard Foundation.
© 2017 Elsevier Inc. All rights reserved.