Table 1. Characteristics of the quantitative studies included in the review.

General article information								Quality score
First author, year of publication, and reference number	Aim(s) and study design	Country and year of study	Study Population and sample size	Data collection method(s)	Outcome measurement	Data analysis	Limitations identified by the author(s)
Abdel-Tawab 2002[47]	• Aims: to examine the feasibility, acceptability, and effectiveness of client-centred models in FP clinics • Design: Cross sectional study	Egypt 1992	• Female family planning client (n= 112) • Mean age= 29 years (range 19-45) • 84% rural • Physician (n= 34) • Mean age = 32 years (range 27-50) • Family planning clinics (n= 31)	Client exit interview, audiotaped data for provider-client interaction data, physician interview	• Client satisfaction was assessed by considering five proxy questions which were rated 0 to 10, with higher score indicating greater satisfaction. • An average satisfaction score (mean score) was calculated and client satisfaction was dichotomized as highly satisfied and less satisfied.	Multivariate logistic regression analysis	No limitation information was provided	Moderate
Agha 2009[41]	• Aim: to compare the quality of family planning services delivered at public and private facilities • Design: Secondary analysis of cross-sectional study	Kenya 2004	Health facilities (n= 323) and family planning clients (n= 628) in a subset of 172 facilities.	Facility inventory, observation, and client exit interviewing	Client satisfaction was assessed through proxy questions and those clients who responded ‘no problem’ to these questions were regarded as satisfied client and otherwise taken as not satisfied.	Multivariate logistic regression analysis	Sample for private facilities was smaller	Moderate
Hutchinson 2011[50]	• Aim: to quantify the differences in the quality of family planning services at public and private providers in three countries • Design: secondary data analysis of cross sectional studies	• Tanzania 2006 • Kenya 2004 • Ghana 2002	• Tanzania: Health facilities (n=482), providers (n=1244), and clients (1005) • Kenya: facilities (n=323), providers (n=860), clients (n=628) • Ghana: facilities (n=386), providers (n=845), clients (n=611)	Data collected through facility survey, observation and client interview	Client satisfaction was measured in two ways. Responses were dichotomized as satisfied if there were ‘no problem’ in proxy questions related to client satisfaction. Additionally, they calculated index of satisfaction using principal component analysis and took as a continuous variable. Factors were identified using both measurements.	Both multivariate linear regression and multivariate logistic regression analysis conducted. The regression analysis were conducted for hospital and clinics separately.	Inability to distinguish between for-profit and not-for-profit private facilities	Moderate
Tafese 2013[55]	• Aim: to assess the quality of family planning services in primary health care centres • Design: Cross-sectional study	Ethiopia 2011	Family planning clients (n=301) mean age (SD)= 26(+5), range (15-45), 61.5% were from rural Health centres (n=5)	Exit-interview of women at facility, and observation of provider-client interactions	Client satisfaction measured through 10 proxy questions and the principal component analysis was used to create an aggregate measure of continuous variable. Each included proxy question was assessed using a 5-points Likert scale (0 to 5)	Multivariate linear regression	Hawthorne effect during provider observation, Courtesy bias during the exit interview and introduction of observer bias	High
Wang 2014[22]	• Aim: to assess the quality of care at health facilities in providing family planning, antenatal care and sick child care • Design: Cross sectional study	• Kenya 2010 • Namibia 2009 • Senegal • 2012/2013	• Kenya: Health facilities (n=575), providers(n=1583), clients (n=1004) • Namibia: • Facilities(n=362), providers (n=966), clients (n=983) • Senegal: • Facilities (n=338), • providers (n=735), clients (n=968)	In all the three countries, data were collected through facility inventory assessment, client exit interview, provider-client interaction observation, provider interview	Client satisfaction variable was rated as an index of problems encountered during the visit (none versus any). Client’s responses for these proxy questions were then aggregated into an index using principal components analysis	Multivariate linear regression	Observer bias and social desirability bias	Moderate
Assaf 2015[49]	• Aim: to examine the quality of care in health facilities in Senegal, with a focus on family planning services • Design: Secondary data analysis of cross-sectional study	Senegal 2012/13and 2014	• Two rounds • Round 1, facilities (n=364), clients (n=872), and provider (n=872) involved • Round 2, facilities (n=363)	Data collections was made in two rounds. Facility inventory survey, observation of provider-client interaction, and providers interviewing were made in each survey periods	Client satisfaction was measured based on a general question about overall client satisfaction on the family planning services. The categories of the responses were very satisfied, more or less satisfied, and not satisfied. Finally they created a binary variable as very satisfied or not satisfied.	Multivariate logistic regression	Social desirability bias, client satisfaction maybe over-reported	Moderate
Argago 2015[48]	• Aim: To assess client satisfactions with family planning services and associated factors • Design: cross-sectional study	Ethiopia 2014	• Family planning clients (n= 324) • Mean age= 28 years (SD=5.57), range (17-42) • 72.8% were repeated users. • Health facilities (n=20)	Client exit interview was conducted	Client satisfaction score was calculated using 18 proxy questions and then binary variable was devised as low and high satisfaction.	Multivariate logistic regression	The study was solely based on client’s information. It did not include provider-client observation or a facility inventory assessment.	Moderate
Nasr 2016[54]	• Aim: to assess the association between quality of family planning services and client satisfaction level • Design: Cross-sectional study	Egypt 2014	• Clients of family planning (n=240) between 20-40years • Mean age=31.6 years (SD= 7.0) • Women at least 2 children • Health facilities (n=10) • Nurses (n=20) • Mean age=36.4 (SD=8.04) • 10 (50%) had less than 5 years of work experiences	Facility survey, observation, and client interview	Client satisfaction measured through Likert scale and then binary outcome variable was created as satisfied and not satisfied.	Chi-square test	No limitation information was provided	Moderate

SD- Standard Deviation