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

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  • Abdel-Tawab, Nahla
  • Roter, Debra

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.

Suggested Citation

  • Abdel-Tawab, Nahla & Roter, Debra, 2002. "The relevance of client-centered communication to family planning settings in developing countries: Lessons from the Egyptian experience," Social Science & Medicine, Elsevier, vol. 54(9), pages 1357-1368, May.
  • Handle: RePEc:eee:socmed:v:54:y:2002:i:9:p:1357-1368
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    Cited by:

    1. Mari Nagai & Saverio Bellizzi & John Murray & Jacqueline Kitong & Esperanza I Cabral & Howard L Sobel, 2019. "Opportunities lost: Barriers to increasing the use of effective contraception in the Philippines," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-15, July.

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