Client Perceptions Research Articles

Surveying dog owners' use and understanding of, and communication with veterinarians about, complementary and alternative veterinary medicine.

Complementary and alternative veterinary medicine (CAVM) seems to be gaining acceptance by pet owners. Client-veterinarian communication about CAVM is important to explore client perceptions and facilitate open exchange of ideas between owners and veterinarians. This study includes an online, cross-sectional survey of dog owners to evaluate CAVM use and client-veterinarian communication about CAVM. Based on the extended theory of planned behaviour, factors influencing the intention to use CAVM were evaluated. Past CAVM use was reported by 45.3% clients based on 1000 valid surveys. The attitude towards CAVM was generally positive. Perceived knowledge about CAVM positively predicted perceived behavioural control and attitude towards CAVM. Both were the strongest predictors of future CAVM use. Around 45.7% of clients had already talked to their veterinarian about CAVM. This conversation was mainly initiated by the owner (66.3%). Owners expected the veterinarian to have knowledge about CAVM (91.5%) and offer referral (71.5%). The limitation is difficulty in classifying and defining CAVM modalities. Owners' perceived behavioural control and attitude towards CAVM predict CAVM use. Failure to engage in a conversation about CAVM hampers clients to partner with veterinarians to discuss the treatment approach and maximise patient outcome. The veterinarian plays an essential role in providing objective accurate information about CAVM.

Perbandingan Tingkat Kepercayaan Peserta Didik Suku Banjar Terhadap Konselor Dan Guru Spiritual (Studi di SMAN 3 Martapura)

The client's trust in the counselor to be open in telling the problem, the client's willingness to come to the counselor, and the client's perception that this does not make the counselor a threat. Likewise, a spiritual teacher who can be trusted (trustworthiness) refers to things that are suggested by the teacher to be done voluntarily by the Banjar community without any coercion. This study aims to analyze the level of trust of students in spiritual counselors and teachers in the aspect of alleviating problems as well as carry out a comparative correlation analysis on comparisons or differences in the level of trust of students in counselors and spiritual teachers at SMAN 3 Martapura. The results of this study show that the independent simple t test has the difference between counselors (80.542 to 2.920) and spiritual teachers (81.970 to 1.492). 95% Confidence Interval of the Difference. The result of Sig. "Levene's Test for Equality of Variances" of 0.000 for counselors and spiritual teachers. Thus, the significant difference between students' trust in counselors and significant differences between students' trust in spiritual teachers does not make students lose their way, students will choose who to trust in helping to alleviate their daily problems. Keywords : Counselors,Learners, Spiritual Teachers.

Therapists and psychotherapy side effects in China: A machine learning-based study

ObjectiveSide effects in the psychotherapy are sometimes unavoidable. Therapists play a significant role in the side effects of psychotherapy, but there have been few quantitative studies on the mechanisms by which therapists contribute to them. MethodsWe designed the Psychotherapy Side Effects Questionnaire-Therapist Version (PSEQ-T) and released it online through an official WeChat account, where 530 therapists participated in the cross-sectional analysis. The therapists were classified into groups with and without perceptions of clients’ side effects. A number of features were selected to distinguish the therapists by category. Six machine learning-based algorithms were selected and trained by our dataset to build classification models. We leveraged the Shapley Additive exPlanations (SHAP) method to quantify the importance of each feature to the therapist categories. ResultsOur study demonstrated the following: (1) Of the therapists, 316 perceived clients’ side effects in psychotherapy, with a incidence of 59.6%; the most common type was “make the clients or patients feel bad” (49.8%). (2) A Random Forest-based machine-learning classifier offered the best predictive performance to distinguish the therapists with and without perceptions of clients' side effects, with an F1 score of 0.722 and an AUC value of 0.717. (3) “Therapists’ psychological activity” was the most relevant feature for distinguishing the therapist category. ConclusionsOur study revealed that the therapist's mastery of the limitations of psychotherapy technology and theory, especially the awareness and construction of their psychological states, was the most critical factor in predicting the therapist's perception of the side effects of psychotherapy.

Client's Perception on Architect's Performance in Contract Administration

Client's Perception on Architect's Performance in Contract Administration

Assessment of Health-Related Quality of Life in Tuberculosis Treatment Centers in a Local Government Area in Southern Nigeria

Background: Studies from Rivers State have demonstrated high burden of drug resistance among pulmonary tuberculosis (PTB) patients and declining cure rate despite adequate treatment retention and highly effective directly observed treatment short-course. Aim: to explore the perception of clients on how PTB disease or its treatment affect their health (health-related quality of life), which could impact on TB treatment success rate among clients with PTB. Methods: A total of 225 adult clients with PTB were recruited by systematic random sampling method from each of the 8 randomly selected centers out of 40 active treatment centers in Obio/Akpor LGA of Rivers State. The SF 36 was used to collect responses which were grouped into 8 domains yielding 2 summary measures. Scores ≤49 were classified as poor, 50-74 relatively favourable and good for scores ≥75. Categorical data were presented as frequencies and proportions using tables and pie charts while quantitative data were presented as means and standard deviations. Results: Specific domains mean scores ranged from 34.9±33.7 (role physical) to 61.8±11.9 (general health) while physical component summary (PCS) and mental component summary (MCS) recorded 53.35±16.79 and 51.11±12.26 respectively. The overall HRQoL mean score for the study was 55.2 (± 3.6) with an undesirable score of 20.7%. Conclusion: Pulmonary tuberculosis patients in treatment centers in Obio / Akpor LGA had poor to relatively favourable HRQoL mean scores. Strengthening counselling practice may help improve support for the clients in coping with the disease and the effect of its treatment.

Self-Awareness and therapeutic alliance in speech-language treatment of traumatic brain injury

Purpose: To investigate the relationships among client self-awareness, client perception of the therapeutic alliance, and speech-language pathologist (SLP) communicative self-awareness in dyads of SLPs and traumatic brain injury (TBI) clients. Method: Nineteen SLP-TBI client dyads (N = 38) engaged in the same collaborative therapy task. At baseline, client self-awareness and client perception of the therapeutic alliance was assessed. SLP communicative self-awareness was measured by 1) a prediction/reflection questionnaire about their own communicative behaviour, administered pre- and post-treatment sessions, and 2) self-evaluation during a novel procedure using video review within three hours after the session. Result: Client self-awareness was not associated with client perceptions of the therapeutic alliance. Client perceptions of the therapeutic alliance were related to specific communicative intentions of the SLP. Regarding SLP communicative self-awareness, SLPs predicted their primary communication modality with 66% accuracy. The video review procedure yielded more detailed SLP communicative self-awareness ratings and was completed within real-world clinical settings. Conclusion: TBI client self-awareness may not impact the establishment of a strong therapeutic alliance between SLP and client. The finding that specific communicative intentions of the SLP were related to client perception of the therapeutic alliance should prompt further efforts to measure SLP communicative intentions and behaviours during TBI treatment sessions.

Perception of Clients Towards the 2D and 3D Types of Design Presentation of the Projects in Interior Design

Interior designers own an exceptional ability to engender novel ideas and solutions. It is important to express or convey this idea to clients effectively so that clients can understand the project. Designers and architects validated that they have two ways to express their ideas or communicate with their clients: 2-D and 3-D presentations. Clients have their own experience and perception of these presentations, based on a few elements that they perceive from this presentation. This paper compares 2-D and 3-D presentations, as well as the elements that shape the client's experiences and the propensity towards 2-D and 3-D presentations. The study attempted to investigate a method for perceiving and persuading clients to accept a creative idea without wasting time. The outcomes of the study can be utilized by the designers and institutes to focus more on this skill, as it plays an undeniable role in interior design as it saves them time and money.

Client and staff perceptions of the integration of trauma informed care and specialist posttraumatic stress disorder treatment in residential treatment facilities for substance use: A qualitative study.

Comorbid posttraumatic stress disorder (PTSD) is prevalent among people seeking residential treatment for substance use disorders (SUD). We examined client and staff perceptions of the relationship between trauma and SUDs, and the integration of trauma-informed care (TIC) and specialist-delivered treatment for PTSD in residential alcohol and other drug (AOD) treatment facilities. Individual semi-structured interviews were conducted with frontline staff (n=20) and clients (n=18) in two residential AOD treatment facilities in Queensland, Australia. Interviews were audio recorded, transcribed and shared client and staff data was analysed using thematic analysis. Major staff and client themes emerged: PTSD was perceived as an underlying cause of SUD, where AOD is used to cope with and avoid PTSD and related symptoms (Theme 1). Residential facilities were perceived to provide a safe and supportive environment for clients (Theme 2). Psychoeducation on SUD and PTSD was also highlighted to normalise experiences associated with comorbid SUD/PTSD and promote help-seeking pathways for specialist PTSD treatment. Concurrent treatment of SUD and PTSD in the residential setting was sought after and was perceived to enhance treatment outcomes (Theme 3). Staff saw the need for implementing TIC into the organisation and perceived TIC as a multi-faceted and consistent approach of service delivery. Both clients and staff perceive comorbid SUD/PTSD as a challenge in residential treatment, that may be overcome through integrating TIC and PTSD treatment in residential treatment facilitates for substance use. Organisational and practical implications are discussed.

Influence of western approach on housing policies and legislation leading to inadvertent institutional discriminatory practice against Aboriginal and Torres Strait Islander people

Housing services in Australia have a foundation of a system developed by English Invaders and, as a result, have limited governing documentation and recommended practice, particularly in Queensland, to operate in a culturally sensitive manner for Aboriginal and Torres Strait Islander traditional owners. This article focuses on a social housing service and the analysis of legislation and social policy, policies and procedures, staff approaches and client perceptions to examine indirect discrimination towards Aboriginal and Torres Strait Islander Australians involved with housing services. Reflective analysis featuring a critical theory lens indicated a disconnect between legislation and social policy with experiences of clients and organisational approaches resulting in shame, feelings of unworthiness and disengagement from these services. Although Queensland housing legislation provides some governing principles protecting the cultural rights of consumers, organisational practice may not always meet this expectation due to ambiguity from industry leaders.

Client preference accommodation for religious/spiritual integration and psychotherapy outcomes in naturalistic practice settings.

The purpose of this practice-research network study was to examine client preferences for religious/spiritual (R/S) integration and test whether preference accommodation in this area is linked to positive treatment outcomes (i.e., less dropout and greater client change). Thirteen independent practice psychotherapists and their 175 clients completed measures of R/S integration preferences and use of R/S techniques and approaches throughout treatment. Psychotherapists also completed an assessment of treatment dropout and change for each participating client. Overall, participating clients expressed moderate preferences for R/S integration, time spent on R/S topics, and an R/S match with their psychotherapists. Preferences in each of these 3 areas were stronger for R/S identifying clients (compared with non-R/S clients) and when clients believed that R/S integration was more essential to produce positive treatment outcomes. Both client R/S identification and client R/S integration preferences predicted psychotherapist's use of R/S techniques in treatment sessions. Importantly, clients' ratings of R/S preference accommodation significantly predicted psychotherapists' ratings of client treatment completion and client change. Specifically, with each unit increase on a 5-point measure of client perceptions of R/S preference accommodation, clients were 1.63 times more likely to be rated as treatment completers and 1.83 times more likely to be identified as having improved while in treatment. Implications for R/S integration in psychotherapy and future research directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multi-Sector Assessment and Client-Perception of Social Need at Long-Term Follow-Up of a Group-Randomized Trial of Community-Engaged Collaborative Care for Adults with Depression.

Understanding client perceptions of need for underlying social determinant support may improve services for depression care. This secondary analysis examines perceptions of “social needs” related to housing and employment, financial, and legal (EFL) concerns among individuals with depression. Data were analyzed from Community Partners in Care, a randomized comparative effectiveness trial of multi-sector collaborative care for depression among a sample of people who were predominantly racial/ethnic minorities and low-income. Adults with depression (n = 980) in both interventions were surveyed at 36-month follow-up for (1) being asked about and (2) having social needs for housing or EFL concerns. In multivariate models, life difficulty and mental health visits in non-healthcare sectors predicted being asked about housing and EFL. Lower social determinants of health-related life satisfaction increased the odds of having unmet housing and EFL needs. These findings underscore the role of non-healthcare organizations as community resources for depression care and in screening and addressing social needs.

Assessment of HIV/AIDS Service Quality Using SERVQUAL Model in Iran: A Cross-sectional Study

Background: This study aimed to evaluate the quality of services provided in Voluntary Counseling and Testing (VCT) centers from the perspective of clients. Methods: This cross-sectional study was conducted on people living with human immunodeficiency virus (PLWH) in Shiraz, Iran, in 2019. The data were collected using a SERVQUAL questionnaire. Results: The mean scores of expected and perceived service qualities were 4.81 (95% CI: 4.741 - 4.864) and 3.96 (95% CI: 3.901 - 4.019) in male subjects and 4.85 (95% CI: 4.80 - 4.89) and 4.09 (95% CI: 4.01 - 4.135) in female subjects, respectively. There was a significant difference between the expectations and perceptions of clients in all dimensions of service quality in VCT centers. The gaps in the dimensions of responsiveness and empathy were greater than all other dimensions. Conclusions: Due to the high dissatisfaction of PLWH with the quality of services in the responsiveness, accessibility, and empathy dimensions, priority should be given to these dimensions in any improvement effort. The low education level of this group should be taken into account for any educational programs to be successful.

Barriers to Accessing Video-Based Telehealth Appointments at a Community Veterinary Clinic During the COVID-19 Pandemic.

ObjectiveTo assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic, to explore the impact of the pandemic on marginalized communities, and to understand perceptions regarding barriers and incentives of telehealth appointments as a method to increase care access.Sample205 active Community Veterinary Medicine Clinic clients at Tufts at Tech Community Veterinary Clinic in Worcester, MA.ProceduresThis cross-sectional study used a survey-based method to assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic. The survey measured client perceptions regarding potential barriers and incentives of telehealth appointments. Participants were randomly sampled from a list of active clients and completed the survey either by email or over the phone. The survey was available in both English and Spanish. Clients who completed the questionnaire received credit for a free examination.ResultsA total of 205 clients submitted survey responses. Factors affecting access to veterinary care were impacted by the COVID-19 pandemic. Access to reliable internet in the home was reported by 87% (n = 177) of participants. Digital access was correlated with education when controlling for race, income, age, and gender. Education was predictive of comfort with using video-chat (χ2 = 65, df = 24, p ≤ 0.01) and of whether or not clients reported need for assistance for using video-chat (χ2 = 52, df = 18, p ≤ 0.01). Patient education level was significantly predictive of wanting to use telehealth for at least one type of appointment (p ≤ 0.05).Conclusions and Clinical RelevanceThe findings indicate that implementing telehealth services at this Community Medicine Clinic is feasible for much of the active clientele and offers a new avenue to provide veterinary care during times of social distancing restrictions and beyond.

Qualitative Study to Support Future Implementation of Peer Support in a Psychiatric Emergency Room Service in Campinas, Brazil

Abstract
 
 Objective: This article describes the findings from a qualitative study conducted in a psychiatric emergency room at the Hospital of the State University of Campinas (Unicamp). Two focus groups collect data from people with serious mental illness (SMI) and professionals from hospital-based psychiatric services (HBPS) to explore challenges and opportunities for future implementation of peer support on Unicamp psychiatric emergency room service in Campinas Brazil. Research Design: The study was conducted in Campinas, Brazil, in January 2020. Volunteers formed two focus groups (n = 10) and discussed relevant questions to implement a peer-based model on the ER psychiatric unit. Methods: Thematic Analysis was used for this study. The sessions were recorded and later transcribed, and data were analyzed and organized in Themes. Results: The research team grouped four themes from the client's perceptions of challenges: lack of access to mental health services, lack of care, treatment voiceless, self-perception about stigma. The client's perceptions of opportunities generate two themes: trust and relationships and appraisal of emotional network and support. The professional's perceptions developed four themes of challenges described as sustainability and adherence to treatment, living with serious mental illness, ER professional roles and limits, and implementation of peer support in the ER. The professional's perceptions of opportunities generated two themes: understanding peer support roles and the positive impact of peer support in the ER. Conclusions: The qualitative data highlights the need for peer support working in the ER psychiatric unit. Also suggested the relevance of large-scale research to build strategies to future implement peer support on the ER psychiatric unit.
 Keywords: 
 Qualitative research, peer support, people with serious mental illness, mental health workers.

Persepsi Klien tentang Bauran Pemasaran terhadap Keputusan Pemilihan Layanan Poliklinik

Background of Study: Th increasing number of hospitals has made the people to free choose services that match their expectations. The number of patient visits at the Outpatient Polyclinic of Bhayangkara Hospital Level III Pattern Bengkulu has decreased from 2016 to 2019. The decision to visit the community is influenced by how they perceive the stimuli they receive in the marketing mix consisting of Product, Price, Promotion and Place. This study aims to determine the relationship between client perceptions of the marketing mix with the decision to choose polyclinic services at Bhayangkara Hospital Level III, Bengkulu City Police.Methods: The research design was cross-sectional. The number of samples were 92 clients who used outpatient poly services taken by accidental sampling technique. The research was held from July to August 2019. The data analysis technique used Chi Square.Results: The results showed that 55.4% of respondents had a good perception of the hospital's marketing mix and 62% of respondents made the decision to re-elect outpatient polyclinic services. Bivariate analysis showed p value = 0.001 which means that there was a relationship between the client’s perception of the marketing mix on the decision to choose an outpatient polyclinic service at Bhayangkara Hospital Level III Bengkulu Police.Conclusion: There is relationship between the client’s perception of the marketing mix on the decision to choose an outpatient hospital polyclinic.Keywords : Marketing Mix, Decision, Election, Polyclinic

"The 'roller coaster ride': A longitudinal investigation of the dynamic relationship between Chinese counseling trainees' self-efficacy and their clients' outcome and the mediating effects of working alliance and session evaluation": Correction to Li et al. (2021).

Reports an error in "The "roller coaster ride": A longitudinal investigation of the dynamic relationship between Chinese counseling trainees' self-efficacy and their clients' outcome and the mediating effects of working alliance and session evaluation" by Xu Li, Feihan Li, Chaihua Lin, Shitao Chen and Yuge Han (Journal of Counseling Psychology, Advanced Online Publication, Nov 29, 2021, np). In the article, the scale for the Working Alliance Inventory-Short Revised (WAI-SR) was incorrectly described in the Measures section as a "5-point scale that ranges from 1 to 5." The WAI-SR used the original 7-point scale ranging from 1 to 7. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-06516-001.) Based on the social-cognitive theory, this study investigated the dynamic association between counseling trainees' self-efficacy and their clients' outcome (i.e., symptom distress), and the mediating effects of therapist- and client-rated working alliance and session quality. Data set included 1,352 sessions conducted by 87 master's level therapist trainees with their 317 clients in China. Before every session, therapists completed a measure of self-efficacy and clients reported their symptom distress; and after every session, both therapists and clients rated their working alliance and session quality. Results showed that, (a) over the course of therapy, the initial level of therapist self-efficacy did not predict how quickly client symptom declined; (b) the initial level of client distress did not predict how quickly therapist self-efficacy increased; and (c) client distress decline was not related to therapist self-efficacy increase over the course of therapy. However, at the session-to-session level, higher therapist self-efficacy before one session significantly predicted lower client distress before the next session, and higher client distress before one session significantly predicted lower therapist self-efficacy before the subsequent session. Therapist and client perceptions of working alliance were both significant mediators, while their session quality ratings were not. Findings supported the dynamic and reciprocal relationship between therapist self-efficacy and client distress at the immediate session-to-session level rather than the overall trajectory level, and revealed its specific mediating mechanism through the relationship building between therapist and client. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The "roller coaster ride": A longitudinal investigation of the dynamic relationship between Chinese counseling trainees' self-efficacy and their clients' outcome and the mediating effects of working alliance and session evaluation.

[Correction Notice: An Erratum for this article was reported in Vol 69(4) of Journal of Counseling Psychology (see record 2022-76740-002). In the article, the scale for the Working Alliance Inventory-Short Revised (WAI-SR) was incorrectly described in the Measures section as a "5-point scale that ranges from 1 to 5." The WAI-SR used the original 7-point scale ranging from 1 to 7. All versions of this article have been corrected.] Based on the social-cognitive theory, this study investigated the dynamic association between counseling trainees' self-efficacy and their clients' outcome (i.e., symptom distress), and the mediating effects of therapist- and client-rated working alliance and session quality. Data set included 1,352 sessions conducted by 87 master's level therapist trainees with their 317 clients in China. Before every session, therapists completed a measure of self-efficacy and clients reported their symptom distress; and after every session, both therapists and clients rated their working alliance and session quality. Results showed that, (a) over the course of therapy, the initial level of therapist self-efficacy did not predict how quickly client symptom declined; (b) the initial level of client distress did not predict how quickly therapist self-efficacy increased; and (c) client distress decline was not related to therapist self-efficacy increase over the course of therapy. However, at the session-to-session level, higher therapist self-efficacy before one session significantly predicted lower client distress before the next session, and higher client distress before one session significantly predicted lower therapist self-efficacy before the subsequent session. Therapist and client perceptions of working alliance were both significant mediators, while their session quality ratings were not. Findings supported the dynamic and reciprocal relationship between therapist self-efficacy and client distress at the immediate session-to-session level rather than the overall trajectory level, and revealed its specific mediating mechanism through the relationship building between therapist and client. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Walking along the same path, or going in different directions? A comparison between the perceptions of translators and clients of translator professionalism in Asia

ABSTRACT Translator professionalism is seldom studied in an empirical way in Asia, not to mention the similarities and differences in the perception of the topic as exhibited by practitioners versus clients. The present study examines translator professionalism as a multidimensional term covering practitioners’ language competency, translation skills, ethics, attitudes, and behaviour in and outside the workplace setting. It compares the viewpoints of 425 practitioners and 72 clients in Asia. Data suggest that both parties have a rather positive attitude towards the professional status of translators although significant divergent viewpoints were found on whether the occupation is vital to society; whether becoming a translator requires a high degree of expertise and knowledge; and whether translators can exercise their own judgment in their jobs. However, both practitioners and clients have similar opinions on translators’ proactive behaviour at work. Moreover, they attach great importance to translators’ adherence to the principles of ethical practice. The findings not only contribute to research on the client-translator relationship but also provide translation teachers and students with knowledge of the latest development of translator professionalism as well as current and upcoming challenges in the industry.

Development and Validation of a Chinese Standardized Client Satisfaction Scale

Purpose: The purpose of this study is to develop and validate a standardized client satisfaction scale for social work programs in China. Method: We generated items through a thorough literature review, confirmed by experts, and indigenized and revised by scholars, practitioners, and clients. The sample was from 15 government-sponsored social work programs’ clients in Jiangsu Province, China. We conducted exploratory factor analyses to test reliability ( N = 299) and confirmatory factor analyses to examine validity ( N = 699). Predictive validity was also tested. Results: The client satisfaction scale, consisting of 4 dimensions with 15 items, demonstrates good internal consistency, satisfactory factorial validity, and positive correlation with clients’ service participation frequency. Discussion: The 4-dimension client satisfaction scale is a reliable and valid instrument. It taps into client perceptions and feedback based on their service experiences. This study offers a feasible way to promote the standardization of social work programs in China.

Perceptions of quality and the integrated delivery of family planning with childhood immunisation services in Kenya and Uganda.

The integration of family planning (FP) with childhood immunisations is considered a promising approach to addressing postpartum women’s unmet need for FP in resource limited settings. This study set out to examine client and health provider perceptions of the quality of FP services that were integrated with childhood immunisations in Kenya and Uganda. Semi-structured interviews with clients (n = 30) and health providers (n = 27) were conducted in 16 rural health facilities. Interviews centred on the respondents’ experiences receiving/delivering FP services, their interactions with providers/clients, and their views on the quality of FP services. Client and provider perceptions of quality were compared through a thematic analysis of interview transcripts, and findings were synthesised using Jain and Hardee’s revised FP Quality of Care Framework. Using audit data, health facility characteristics and resources were also summarised through descriptive statistics to contextualise the qualitative findings. The dignity and respect experienced by clients was central to the respondents’ perceptions of quality. These two dimensions were not conceptualised as distinct facets of quality, but were instead perceived to be a product of the 1) access to needed services, 2) choice of contraceptives, 3) interpersonal communication, 4) information, and 5) confidentiality afforded to clients. Additionally, clients and providers alike believed that the integration of FP services with childhood immunisations had a positive effect on clients’ access to needed services and on the confidentiality they experienced in a context where modern contraceptive use was stigmatised and where a lack of support from some husbands impeded access to FP services. Understanding clients’ and providers’ conceptualisation of quality is critical to the design of high quality and client-centred integrated FP services.