Boosting Rapport and Respect in Outpatient Consultations


  • Respectful care from healthcare providers helps clients feel comfortable sharing their concerns openly with their providers and seeking the services they need.
  • When clients share openly, providers are better prepared to respond to their needs.
  • Solutions can build rapport and open communication between providers and clients through mutually reinforcing commitments from both parties.


The Challenge

In Tanzania, as in many other settings, healthcare providers sometimes mistreat clients by scolding, shouting, or providing non-consented care. Providers also sometimes deny services to clients based on their marital or socioeconomic status. Fearing a negative experience, clients may sometimes hesitate to seek health services or share their questions and concerns with providers.

Respectful client care—such as treating clients courteously, keeping clients’ information confidential, and listening attentively to their concerns and questions— helps clients feel more comfortable sharing their concerns openly with their providers and seeking the services they need. Similarly, when clients openly share their needs, follow providers’ guidance, and give honest feedback on their experience, providers are better able to see the impact of their actions and to respond to clients’ needs and priorities. 

Respectful client care can improve client experience, increase service utilization, and strengthen provider-client rapport, generating a virtuous cycle that enables providers to more consistently and easily provide good care in the future.



Our Approach

We worked in Tanzania under the USAID- funded Breakthrough ACTION project to boost rapport, trust, and positive interactions between clients and providers. Collaborating with local stakeholders, we built on insights related to respectful provider behavior and adapted solutions from our previous work in Zambia, Liberia, and Niger to the Tanzanian context. 

Woven through all the solutions is a “Promise for Good Health” that lays out three simple commitments from both providers and clients to work together toward the shared goal of good health. Specific components include:

  • A reflection and support activity through which providers reflect on what good care is and how it can impact clients and learn from peers about how to overcome challenges to respectful care.
  • A job aid providers use at the outset of each consultation to make a promise to the client and to ask the client to make a promise to them.
  • Mass media campaigns, including billboards, posters, and audio/video spots that highlight relatable experiences from providers and clients and extend the “promise” to encourage clients to visit the health facility.

The solutions aim to build rapport between providers and clients, create mutually reinforcing commitments from both parties, and encourage providers to motivate and support one another when they encounter challenges.



Simple tools and cues can reassure both providers and clients and encourage good rapport and respectful care. As a result, clients can feel more comfortable seeking the services they need, and providers can better respond to clients’ needs and priorities. 

Interested in our work applying behavioral science to global health? Email, follow us on LinkedIn, or tweet at @ideas42 to join the conversation.