title: Performances of sexuality counselling: a framework for provider-client encounters.
abstract: OBJECTIVE
  Adequately assessing quality of care poses enormous challenges. While conducting fieldwork, we were struck by the need for a framework that encapsulates provider-client encounters. Little evidence exists concerning the most effective training, and management of health staff engaged in sexuality, reproductive health and HIV related health services. This paper proposes a framework for analysing these encounters.
  
  
  METHODS
  This paper is based on five studies. Mixed method studies were carried out in Uganda and Kenya. Two additional studies looked into the effect of HIV on health worker performance in Uganda and Zambia. As a result of the findings, a desk review looked into factors affecting provider-client encounters in order to improve the responsiveness of programs.
  
  
  RESULTS
  Positive encounters between provider and client are built on trust and respect, consist of communication, practice and process, and are influenced by space, place and context. Combining these facets allows for a better understanding of their interactions.
  
  
  CONCLUSIONS
  A holistic perspective in which the breadth of dynamics and processes are described should be used when assessing the quality of provider-client encounters.
  
  
  CONCLUSIONS
  Within training, management and human resource planning, these dynamics need to be utilized to realize the best possible care.
authors.affiliation: Royal Tropical Institute, Development Policy and Practice, Amsterdam, The Netherlands. a.v.d.kwaak@kit.nl
authors.forename: Anke
authors.initials: A
authors.lastname: van der Kwaak
authors.forename: Kristina
authors.initials: K
authors.lastname: Ferris
authors.forename: Jetty
authors.initials: J
authors.lastname: van Kats
authors.forename: Marjolein
authors.initials: M
authors.lastname: Dieleman
mesh_terms: D006282:Health Personnel; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods; D006801:Humans; D007630:Kenya; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D012731:Sex Counseling; D014454:Uganda; D015024:Zambia