Challenging the Courtesy Bias Interpretation of Favorable Clients’ Perceptions of Family Planning Delivery

• Published in: Evaluation review Vol. 31; no. 1; pp. 24 - 42
• Main Authors: León, Federico R., Lundgren, Rebecka, Huapaya, Ana, Sinai, Irit, Jennings, Victoria
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA SAGE Publications 01.02.2007; SAGE PUBLICATIONS, INC
• Subjects: Bias; Birth control; Clinics; Communication; Contraception; Contraceptive Agents, Female - supply & distribution; Contraceptives; Courtesy; Cross cultural studies; Cross-Cultural Comparison; Cross-national analysis; Family Planning; Family Planning Services - standards; Female; Foreign Countries; Health technology assessment; Humans; India; Interpersonal relations; Interviews as Topic; Patient Simulation; Perceptions; Peru; Pregnancy; Privacy; Professional-Patient Relations; Prosocial behavior; Public health; Qualitative analysis; Qualitative Research; Questionnaires; Rwanda; Simulated clients; Surveys and Questionnaires; Peru; Rwanda; India; family planning delivery; client exit interview; service test; courtesy bias
• ISSN: 0193-841X; 1552-3926
• DOI: 10.1177/0193841X06289044

Favorable client perceptions of provider’s interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients’ courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three countries. Providers excelled in courteousness/respect in Peru and Rwanda; in India, providers were less courteous and respectful when the simulated clients chose the pill. Privacy and two-way communication were less prevalent in all three countries. The findings challenge the courtesy bias interpretation. Global results from qualitative studies may have expressed the views of the minority of clients who are not treated well by providers.