Performances of sexuality counselling: a framework for provider-client encounters

OBJECTIVE: Adequately assessing quality of care poses enormous challenges. While conducting fieldwork, we were struck by the need for a framework that encapsulates provider-client encounters. Little evidence exists concerning the most effective training, and management of health staff engaged in sexuality, reproductive health and HIV related health services. This paper proposes a framework for analysing these encounters.

METHODS: This paper is based on five studies. Mixed method studies were carried out in Uganda and Kenya. Two additional studies looked into the effect of HIV on health worker performance in Uganda and Zambia. As a result of the findings, a desk review looked into factors affecting provider-client encounters in order to improve the responsiveness of programs.

RESULTS: Positive encounters between provider and client are built on trust and respect, consist of communication, practice and process, and are influenced by space, place and context. Combining these facets allows for a better understanding of their interactions.

CONCLUSION: A holistic perspective in which the breadth of dynamics and processes are described should be used when assessing the quality of provider-client encounters.

PRACTICE IMPLICATIONS: Within training, management and human resource planning, these dynamics need to be utilized to realize the best possible care.