The unweighted average NQCI score for the 30 countries (60; Table 3) was similar to the corresponding quality scores from the Family Planning Effort survey (56) and the NCIFP (55).
First, equal weights were assigned to the Availability, Information and Success indicators in estimating the composite NQCI score.
The NQCI index proposed here offers a way to measure and monitor national-level quality routinely.
Because the NQCI score is based equally on scores from its three component indices, one would expect the NQCI to be correlated with each of them.
For example, research on contraceptive users in the Philippines who had had an unwanted birth--an outcome similar to the NQCI's success indicator--found the relationship between structure and process indices at the individual level to be weak, but the relationship between process and outcome indicators at that level to be strong.
One may be tempted to conclude that the lack of correlation between Success Index and NQCI scores, or between values on the Success and Information indices, suggests that fertility outcomes are not strongly influenced by quality, but rather reflect the influence of other, more important factors (such as demand for and motivation to use contraceptives).
Data from Service Provision Assessment-type facility surveys are not strictly comparable to the data used to calculate scores for the three components of the NQCI, and were not used to validate the Method Availability and Method Information indices used in this study.
However, a good program needs to pay attention to both dimensions of services--quantity and quality--and can measure its success by monitoring its NQCI score along with mCPR.
Scores for all three indicators of quality (NQCI, NCIFP and the Family Planning Effort quality indicator) were correlated with each other and seem to move in the same direction, despite there being very little overlap between the data used in the NQCI and those used in the other indicators.
In contrast, two of the NQCI's three dimensions of quality are measured using the responses of women themselves, which may be an attractive feature.