Did you know that clients often withhold information during their interactions with health workers and sometimes the information withheld can have adverse consequences on the quality of care they receive? Why would a client who has come to receive care at a facility withhold critical information yet their coming to the facility is a sign of trust in the system?  

Findings from Ghana revealed that pregnant women often withhold information from the health workers during antenatal care, delivery and the postpartum period. Women who had experienced poor health worker attitudes during consultation were more likely to withhold information related to parity, gynecological problems, chronic illness or any other complications that would raise judgment and lead to humiliation. The information provided greatly affects the decisions taken by the health workers during management of the clients right from antenatal care, delivery and postnatal period. Health workers who do not receive the right information from pregnant women miss out the ‘’high risk’’ pregnancies which have a high likelihood of maternal complications and even death.  This is a great hindrance to achievement of millennium development goal 4 and 5.

According to the voices that emerged from the health facility managers, humiliation of clients is mostly fueled by the frustration brought about by a number of factors including; work overload-especially in the rural districts where the policy of maternal services greatly increased the workload in health facilities that were already short of health workers. Poor client-health worker relationships emerged as major reason for withholding critical information. Women were afraid of being scolded and embarrassed incase they disclosed information that would trigger judgment from the health worker. Many women often keep quite during consultation or simply said what they persived would not trigger anger from the health workers. …If I remain silent, then am not humiliated (pregnant women)

Finding from Ghana revealed the despite the good protocols and treatment guidelines available at health facility level, clinical decision making and management of pregnant women is  greatly affected  by the  client-provider relationship. It is important that at  each antenatal appointment, midwives and doctors offer clear explanations as to why disclosure of any complications and medical history is critical for the mother and newborn. This provides pregnant women with an opportunity to discuss issues in an environment that allows for confidentiality.

image courtesy of Google image

References

1. Cowger, Charles D. "Assessing client strengths: Clinical assessment for client empowerment." Social Work 39.3 (1994): 262-268.

2. Piercy, Kathleen W., and Dorothy N. Woolley. "Negotiating worker-client relationships: A necessary step to providing quality home health care." Home health care services quarterly 18.1 (2000): 1-24.