Provider Behavior Change


It is widely known that healthcare providers are often limited by their own misconceptions and biases in offering quality reproductive health information related to family planning, contraceptive counseling and services to women or couples. As such, the key to improving the supply and use of contraceptive methods is to help providers overcome their own biases and offer client-focused services.

Healthcare Provider Barriers to Family Planning Service Delivery in Côte d’Ivoire

The project first started with a literature review related to the supply of FP services in West Africa and was followed by 15 focus groups with 107 providers in 6 regions in Côte d’Ivoire. The discussions led to the pre-selection of 30 proposed positive deviant providers.  Such providers were visited by 30 mystery clients to validate the selection. At the end, 15 in-depth individual interviews were held with 15 providers identified as positive deviants.

Three major categories of barriers in the supply of FP services were identified: a) organizational barriers such as lack of appropriate materials or appropriate structures, b) community barriers such as the influence of cultural or religious values, and c) personal barriers based on client characteristics such as age, marital status or parity.

It was concluded that positive deviant providers are characterized from the point of view of the client by the quality of their service, confidentiality, the effective communication and finally by their availability to prescribe and accurately provide information about the methods. The elements that enable positive deviant providers to overcome barriers lies on their motivation (the love of the trade), continuous capacity building, exceptional work experiences and innovative communication strategies.

The technique of identifying positive deviants was also used to identify best practices. At the end of the analysis, it can be retained that positive deviants offer the full range of FP services to clients demonstrating empathy and good listening skills that enhance the client’s likelihood to adopt and continue using a modern method of contraception.


Analysis of Obstacles and Barriers to the Offer of Family Planning by Providers

Provider barriers in Cote d’Ivoire are not too different than those found in the region and worldwide. The most important limitations observed are personal biases,

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