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Paternalistic models of health care, social distance between patients and providers, and cultural norms discourage patients from playing an active role in health consultations. This study tested whether individual coaching can give family planning patients the confidence and communication skills to talk more openly and more vigorously with providers.(More)
Researchers observed 418 consultations with clients aged 12-24 years at 38 health facilities throughout Zimbabwe and interviewed both the clients and providers. Less than one per cent of clients at these facilities were aged 12-14 years; between 5% and 20% were aged 15-19 years. Compared with older clients, those aged 12-16 years came more often for(More)
OBJECTIVE The World Health Organization has led the development of a Decision-Making Tool for Family Planning Clients and Providers (DMT) to improve the quality of family planning counseling. This study investigates the DMT's impact on health communication in Nicaragua. METHODS Fifty nine service providers in Nicaragua were videotaped with 426 family(More)
Patient participation in health care consultations can improve the quality of decision making and increase patients' commitment to the treatment plan. This study examines client participation, operationally defined as client active communication, during family planning consultations in Indonesia. Data were collected on 1203 consultations in the provinces of(More)
Family planning programs are increasingly making quality of care the highest priority. With improvement in quality of care, contraceptive use is safer and more effective, information and services are more accessible, clients make informed choices and are more satisfied. In addition, family planning providers find their work more rewarding and the general(More)
The opinions expressed herein are those of the author and do not necessarily reflect the view of USAID. SUMMARY Context: Paternalistic models of health care, social distance between clients and service providers, and cultural norms discourage family planning clients from playing an active role in consultations. Interventions are needed to encourage clients(More)
OBJECTIVE To determine whether supervision and self-assessment activities can improve doctor-patient communication. SETTING AND PARTICIPANTS Six supervisors, 60 doctors in their last year of training, and 232 primary health care patients at rural health clinics in Michoacan, Mexico. DESIGN The main evaluation compared post-intervention measures in(More)