"… the way we welcome them is how we will lead them to love family planning.": family planning providers in Rwanda foster compassionate relationships with clients despite workplace challenges.
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
01 Apr 2021
01 Apr 2021
Historique:
received:
18
12
2020
accepted:
16
02
2021
entrez:
2
4
2021
pubmed:
3
4
2021
medline:
15
5
2021
Statut:
epublish
Résumé
Rwanda has markedly increased the nation's contraceptive use in a short period of time, tripling contraceptive prevalence in just 5 years between 2005 and 2010. An integral aspect of family planning programs is the interactions between family planning providers and clients. This study aims to understand the client-provider relationship in the Rwandan family planning program and to also examine barriers to those relationships. This qualitative study in Rwanda utilized convenience sampling to include eight focus group discussions with family planning providers, both family planning nurses and community health workers, as well as in-depth interviews with 32 experienced modern contraceptive users. Study participants were drawn from the two districts in Rwanda with the highest and lowest modern contraceptive rates, Musanze and Nyamasheke, respectively Data analysis was guided by the thematic content approach, Atlas.ti 8 was utilized for coding the transcripts and collating the coding results, and Microsoft Excel for analyzing the data within code. Data analysis revealed that, despite workplace related challenges - including inadequate staffing, training, and resources, relationships between providers and clients are strong. Family planning providers work hard to understand, learn from, and support clients in their initiation and sustained use of contraceptives. Given the existing context of purposeful efforts on the part of family planning providers to build relationships with their clients, if the current level of government support for family planning service provision is enhanced, Rwanda will likely sustain many current users of contraception and engage even more Rwandans in contraceptive services in the future.
Sections du résumé
BACKGROUND
BACKGROUND
Rwanda has markedly increased the nation's contraceptive use in a short period of time, tripling contraceptive prevalence in just 5 years between 2005 and 2010. An integral aspect of family planning programs is the interactions between family planning providers and clients. This study aims to understand the client-provider relationship in the Rwandan family planning program and to also examine barriers to those relationships.
METHODS
METHODS
This qualitative study in Rwanda utilized convenience sampling to include eight focus group discussions with family planning providers, both family planning nurses and community health workers, as well as in-depth interviews with 32 experienced modern contraceptive users. Study participants were drawn from the two districts in Rwanda with the highest and lowest modern contraceptive rates, Musanze and Nyamasheke, respectively Data analysis was guided by the thematic content approach, Atlas.ti 8 was utilized for coding the transcripts and collating the coding results, and Microsoft Excel for analyzing the data within code.
RESULTS
RESULTS
Data analysis revealed that, despite workplace related challenges - including inadequate staffing, training, and resources, relationships between providers and clients are strong. Family planning providers work hard to understand, learn from, and support clients in their initiation and sustained use of contraceptives.
CONCLUSION
CONCLUSIONS
Given the existing context of purposeful efforts on the part of family planning providers to build relationships with their clients, if the current level of government support for family planning service provision is enhanced, Rwanda will likely sustain many current users of contraception and engage even more Rwandans in contraceptive services in the future.
Identifiants
pubmed: 33794871
doi: 10.1186/s12913-021-06282-x
pii: 10.1186/s12913-021-06282-x
pmc: PMC8017655
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
293Références
Stud Fam Plann. 1990 Mar-Apr;21(2):61-91
pubmed: 2191476
Reprod Health Matters. 2012 Jun;20(39):50-61
pubmed: 22789082
PLoS One. 2017 Jan 17;12(1):e0170217
pubmed: 28095475
Health Serv Res. 1999 Dec;34(5 Pt 2):1189-208
pubmed: 10591279
Int J Gynaecol Obstet. 2019 Feb;144(2):153-160
pubmed: 30407627
Int Perspect Sex Reprod Health. 2013 Sep;39(3):133-41
pubmed: 24135045
BMC Health Serv Res. 2006 Jun 22;6:79
pubmed: 16792810
Lancet. 2004 Sep 4-10;364(9437):900-6
pubmed: 15351199
Contracept Reprod Med. 2018 Nov 20;3:18
pubmed: 30479830
Global Health. 2015 Aug 15;11:36
pubmed: 26276053
Stud Fam Plann. 2001 Dec;32(4):302-14
pubmed: 11831049
Stud Fam Plann. 1992 Nov-Dec;23(6 Pt 1):392-5
pubmed: 1293863
Health Policy Plan. 2018 Sep 1;33(7):828-839
pubmed: 30010860
Cochrane Database Syst Rev. 2013 Oct 26;(10):CD004317
pubmed: 24163097
Int J Gynaecol Obstet. 2015 Oct;131 Suppl 1:S49-52
pubmed: 26433506
Afr J Reprod Health. 2003 Aug;7(2):57-73
pubmed: 14677301
Lancet. 2012 Jul 14;380(9837):149-56
pubmed: 22784533
Stud Fam Plann. 1997 Dec;28(4):278-89
pubmed: 9431649
Afr J Reprod Health. 2016 Jun;20(2):62-71
pubmed: 29553165
PLoS One. 2016 Nov 3;11(11):e0165627
pubmed: 27812124
Qual Quant. 2018;52(4):1893-1907
pubmed: 29937585
SSM Popul Health. 2016 Dec;2:640-655
pubmed: 28345016
J Fam Plann Reprod Health Care. 2008 Jan;34(1):37-41
pubmed: 18201405
J Fam Plann Reprod Health Care. 2013 Jan;39(1):29-35
pubmed: 22906857
Stud Fam Plann. 2018 Jun;49(2):171-179
pubmed: 29708277
Clin Obstet Gynecol. 2014 Dec;57(4):659-73
pubmed: 25264697
Stud Fam Plann. 2003 Dec;34(4):227-48
pubmed: 14758606
Int Perspect Sex Reprod Health. 2011 Dec;37(4):209-16
pubmed: 22227628