Provider empathy and person-based care

Enhancing provider-client interactions is key to improving family planning and reproductive health (FP/RH) services. To support this, MOMENTUM Safe Surgery in Family Planning and Obstetrics (MSSFPO) introduced innovative self-learning video modules for Accredited Social Health Activists (ASHAs) in India. A key focus was strengthening the capacity of frontline workers to deliver quality FP services. In 2023, the project developed 18–20-minute self-learning video modules in Hindi and Kannada with English subtitles. These videos aimed to strengthen ASHAs' ability to provide empathetic, client-centered FP counseling-fostering understanding, active listening, and compassion in their interactions. The modules covered topics such as customizing approaches for diverse clients, engaging male partners, and adopting the REDI (Rapport Building, Exploring, Decision Making, and Implementing) framework. To ensure their effectiveness and relevance, video prototypes were pretested with ASHAs in Chhattisgarh and Karnataka states using the 5E framework. This evaluation assessed the videos' impact on ASHAs' counseling abilities, engagement, and usability. Insights from the pretest led to refinements, ensuring the tools effectively support ASHAs in delivering empathetic, high-quality FP counseling. Implemented by JHCCP and CCC-I), the initiative strengthened ASHAs' ability to foster trust, address client concerns, and provide clear, compassionate guidance-ultimately enhancing the quality of FP/RH services.

We co-created and piloted a new model of person-centred care with eight rural and peri-urban public clinics in South Africa to explore whether a supportive and participatory approach could improve healthcare providers' motivation and empathy. 
Traditional person-centred care initiatives often rely on monitoring and accountability, which many providers perceive as punitive and unhelpful. In contrast, this model was developed collaboratively with nurses, drawing on their ideas about what helps them remain motivated and compassionate-factors like connectedness, appreciation, learning opportunities, constructive feedback, and teamwork.
Over 18 months, clinics engaged in an iterative process of training, mentoring, review and reflection, and planning, led by a roving nurse mentor in partnership with the clinic managers. Weekly sessions addressed empathy, patient mindsets and barriers, communication, stress management, teamwork, and supportive supervision.
Using a mixed-methods design, we collected data through surveys (n=60), interviews (n=60 total across rounds), and focus groups (n=50). Findings from the interviews and focus group discussions showed strong acceptability and feasibility, with providers describing the model as empowering and affirming. Quantitative survey results also indicated improvements in various workplace factors over time.
The pilot demonstrated that involving providers in designing person-centred interventions can strengthen empathy, motivation, and job satisfaction while enhancing patient experience of care. However, person-centred care alone cannot overcome structural barriers such as overcrowding and long waiting times, underscoring the ongoing need for broader health system strengthening.

In Northern Nigeria, where early marriage and social norms restrict girls' choices, sustaining contraceptive use among married adolescents requires more than access but demands trust, empathy, and communication that centres their voices. Through the global A360 initiative led by Population Services International (PSI) and implemented in Nigeria by Society for Family Health (SFH), the Counselling for Choice (C4C) approach transformed contraceptive counselling into a relational experience grounded in empathy and informed choice.
C4C equipped providers in 30 public facilities with tools like the Choice Book and NORMAL guide to reframe counselling as a dialogue, not persuasion, where girls are heard, prepared for side effects, and supported to act on their own decisions. A mixed-methods evaluation involving over 2,600 adolescents revealed remarkable gains: contraceptive continuation rose from 191 to 1,975 users in intervention sites, while 98% of clients understood their follow-up plan and 61% reported full decision-making autonomy.
Girls described feeling respected and confident: "The provider didn't choose for me; she helped me choose for myself." Providers, too, reported greater trust and fewer complaints.
This experience demonstrates that when communication is empathetic and rights-based, it builds relationships that sustain behaviour change. Continuation becomes more than a metric, it becomes a marker of trust, dignity, and shared accountability between young women and the systems that serve them. C4C exemplifies how SBCC grounded in connection and collaboration can turn service delivery into empowerment.

Key to improving health globally is mothers' adoption of healthy practices in the first 1000 days. This challenge is acute where access to health information is poor, educational levels are low, and traditional beliefs are strong. Better interpersonal relationships and trust are needed between health care workers, community health workers (CHWs), and mothers/families. A new learning/teaching method called "Sharing Histories"(SH) was developed and tested to improve the performance of female CHWs for promotion of maternal, neonatal, and child health. The method builds on shared childbearing and child-care experiences of CHWs who become empowered to change, and to better convince mothers to change using the same method. The SH teaching method tested using mixed-methods research including a cluster-randomized controlled trial (cRCT) with 22 health facility areas (clusters) in a population of 82,000 inhabitants in rural Huánuco Region on the eastern slope of the Andes mountains in Peru. Empirical research from developmental psychology, communications, and neuroscience helps to explain how this method works to improve MNCH behaviors, particularly research on the functions of autobiographical memories. The cRCT showed significant differences in reduction of child stunting in the experimental community clusters versus control clusters. Generalized estimating equations and difference in differences were used for statistical testing, controlling for clustering. Qualitative studies helped to explain findings. For primary health care (PHC) services with health care staff who are not educators, the SH teaching method for CHWs, and mothers, is low cost and easy to learn for incorporation into government CHW programs.