Addressing provider behavior and drivers of provider biases towards youth clients in contraceptive service delivery – either due to age, marital status, parity, social economic background or education status/level – calls for a deeper contextual understanding of social cultural norms that govern patient-doctor interactions as well as a slew of other prevailing structural factors. Lessons from the Beyond Bias project provide compelling insights about the limitation of current approaches used to address provider bias and measure client experience of bias.
A rigorous multi-disciplinary approach that combined adolescents and youth sexual and reproductive health (AYSRH) evidence and best practices with behavioral economics and market research methodologies including human centered design (HCD) and segmentation analysis unveiled the intricacies of provider bias and informed the development of a novel behavior change strategy. The model incorporates solutions that employ the power of storytelling to illuminate experiences of clients and the struggles of providers in serving youth clients.
A randomized controlled trial (RCT) was used to evaluate the model. Findings show the model had significant improvements in provider attitudes/beliefs, counseling quality, and client experiences. However, no changes were observed in method dispensation i.e., method of choice received by clients, begging the question: Does comprehensive counseling lead to a change in method of choice? OR Is method mix a good indicator of informed choice? Future evaluation efforts to assess the effectiveness of the Beyond Bias model or other work on provider behavior should consider use
of stories/vignettes to explore these important questions.