Abstract
Health Communication. 1999. 11(1): 1-19.This study analyzed transcripts from 178/358 family planning counseling sessions conducted in a total of six local languages and recorded at 25 service delivery sites as part of the 1993 Kenya Provider and Client Information, Education, and Communication Project. The study goals were to 1) discover whether and how clients participate in the counseling process and identify specific ways that clients play an active role, 2) assess whether and how providers influence client participation and how they react when clients take an active role, and 3) quantify interaction in the counseling process. Data were also gathered at follow-up 18 months later during which an additional 10 counseling sessions at clinics scattered throughout Kenya were observed, and in-depth interviews were conducted with clients and providers. The transcripts were coded and analyzed to determine interaction style, balance of talk, proportion of active client communication, types of active client communication speeches, promotion of client communication by the provider (nine categories), and whether the provider rewarded active participation. Analysis revealed that providers dominated the interactions and spoke 66% of the total number of sentences. Clients generally participated by elaborating on their responses to direct questions, so encouraging full answers to questions would be a natural way to increase client participation. Counselors can also build a sense of rapport with clients, relate contraceptive information specific to client needs, and reward client attempts to participate.
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