The relevance of client-centered communication to family planning settings in developing countries: Lessons from the Egyptian experience

Nahla Abdel-Tawab, Debra Roter

Research output: Contribution to journalArticlepeer-review

Abstract

Concern for client's rights in the provision of reproductive health services in the developing world has prompted intense efforts by international experts to promote client-centered models of communication as a replacement for more provider-centered approaches. Nonetheless, the usefulness or feasibility of cross-cultural transplantation of client-centered models of communication has not been examined.The present study examines the feasibility, acceptability, and effectiveness of client-centered models of communication in 31 family planning clinics in Egypt. Consultations between 34 physicians and 112 clients requesting family planning methods were audio-taped and analyzed for physician communication style. Client satisfaction was measured through exit interviews. Method continuation was determined through home interviews at 3 and 7 months from the index visit.Based on audio-tape analysis, two-thirds of physician consultations were characterized as physician-centered and one-third as client-centered. Client-centered consultations were only one minute longer than physician-centered consultations. A client-centered consultation was associated with a three-fold increase in the likelihood of client satisfaction and method continuation at 7 months. A high proportion of solidarity statements (positive talk) by the physician was predictive of client satisfaction whereas a high proportion of disagreement statements and directive instructions by the physician were predictive of method discontinuation.The study findings suggest that in Egypt, as in more developed countries, client-centered models of communication are likely to produce better client outcomes than provider-centered models, with no substantial changes in the structure of services.

Original languageEnglish (US)
Pages (from-to)1357-1368
Number of pages12
JournalSocial Science and Medicine
Volume54
Issue number9
DOIs
StatePublished - Jan 1 2002

Keywords

  • Egypt
  • Family planning counseling
  • Provider-client communication
  • Satisfaction

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

Fingerprint Dive into the research topics of 'The relevance of client-centered communication to family planning settings in developing countries: Lessons from the Egyptian experience'. Together they form a unique fingerprint.

Cite this