What should I know before beginning implementation?
Respect and trust in a health setting should be reciprocated between patients and providers. While sometimes overlooked, patient respect for providers is a critical part of experiential quality of care and is often influenced by patient perceptions of provider attitudes, competence, and caring behaviors.5 In fact, an evaluation of the Brazilian primary health care system found that facility infrastructure and resources – while important for coordination and access – were not associated with higher reports of respect for cultural practices.6 Respect is also related to timeliness and fair treatment. Providers can demonstrate respect for patient time if patients are seen quickly with adequate consultation times and do not face discrimination.
When patients feel they are respected by providers and they trust providers’ judgment, they may be more likely to seek care when needed, enabling them to develop continuous, lasting relationships with providers. Alternatively, if patients do not feel respected by providers, they may be deterred from seeking care, exacerbating poor health outcomes.7 This is particularly detrimental in low and middle-income settings where providers may be scarce and patients do not necessarily have the ability to switch providers at will.8
The suggestions below are grouped into three different considerations and relate to both provider trust and respect of patients as well as patient respect and trust of providers: 1) Communication and engagement, 2) facility-level interventions for providers, and 3) Disrespect and abuse literature. We have found that there is a significant gap in the literature in terms of interventions to promote respectful care. Instead, most interventions and strategies focus on the prevention of disrespectful care which – although an important start – is not sufficient to ensure that patients have access to respectful and trusting care.9