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Evaluation Review, Vol. 31, No. 1, 24-42 (2007)
DOI: 10.1177/0193841X06289044
© 2007 SAGE Publications

Challenging the Courtesy Bias Interpretation of Favorable Clients’ Perceptions of Family Planning Delivery

Federico R. León

Georgetown University Institute for Reproductive Health

Rebecka Lundgren

Georgetown University Institute for Reproductive Health

Ana Huapaya

Instituto de Salud Reproductiva, Lima, Peru

Irit Sinai

Georgetown University Institute for Reproductive Health

Victoria Jennings

Georgetown University Institute for Reproductive Health

Favorable client perceptions of provider’s interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients’ courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three countries. Providers excelled in courteousness/respect in Peru and Rwanda; in India, providers were less courteous and respectful when the simulated clients chose the pill. Privacy and two-way communication were less prevalent in all three countries. The findings challenge the courtesy bias interpretation. Global results from qualitative studies may have expressed the views of the minority of clients who are not treated well by providers.

Key Words: courtesy bias • family planning delivery • service test • client exit interview


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This article has been cited by other articles:


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 Eval Health ProfHome page
F. R. Leon, R. Lundgren, and V. Jennings
Provider Selection of Evidence-Based Contraception Guidelines in Service Provision: A Study in India, Peru, and Rwanda
Eval Health Prof, March 1, 2008; 31(1): 3 - 21.
[Abstract] [PDF]

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 Eval RevHome page
F. R. Leon, M. Arevalo, R. Lundgren, V. Jennings, A. Huapaya, and R. Panfichi
Four Criteria to Evaluate Providers' Service-Delivery Response to New Contraceptive Introduction
Eval Rev, August 1, 2007; 31(4): 364 - 390.
[Abstract] [PDF]