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Many women experience gender-related sociocultural, physical, and financial barriers that constrain their ability to seek care.Although family planning programs are paying more attention to men's and couples' roles as clients, most programs still deal primarily with women.Even if public transportation is available, traveling alone may not be socially acceptable for women.
Understanding clients' beliefs can help providers align their services with these ideas or, when necessary, address local misconceptions.
Providers can also bridge such gaps by expressing respect for the clients' beliefs and drawing connections between these beliefs and medical models of health (Hodgins 2000; Delbanco and Daley 1996).
In a study in Pakistan, researchers found that 76 percent of husbands and 66 percent of wives feared that God would become angry if they practiced family planning (Population Council 1997).
Family planning methods may challenge bio-cultural beliefs.
In Kenya, one study participant said that using oral contraceptives "can cause blood to flow out of the nose and mouth, and can cause delivery of children with two heads or no skin" (Rutenberg and Watkins 1997: 297).
The existence of such beliefs highlights the importance of counseling about the advantages and disadvantages of contraceptive methods.
These client perceptions are in turn affected by personal, social, and cultural factors.
Research highlights the benefits of addressing client perspectives on quality of care, since it leads to improved client satisfaction, continued and sustained use of services, and improved health outcomes (Bertrand et al. Clients' perspectives on quality affect their behavior both before and during the time of service.
Costs Costs, including fees for transportation, services, and supplies, can be another barrier to care.
In the 2000 Cambodia Demographic and Health Survey (DHS), women said that lack of money was the main obstruction to obtaining health care (National Institute of Statistics and ORC Macro 2000).
Recent research in northern Ghana found that women who chose to practice contraception risked social ostracism or familial conflict (Adongo et al. In some areas, women need their husband's permission to visit a health facility or to travel unaccompanied, which may result in either clandestine or limited use of contraceptives (see the section on confidentiality on page 5; Biddlecom and Fapohunda 1998).Tags: Adult Dating, affair dating, sex dating