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
By Shawn Malone, Project Director, The Mpilo Project, PSI South Africa
This World Health Workers Week, we’re reminded of the essential role that empathy plays in strengthening person-centered care.
This week-long celebration is meant to encourage appreciation of the essential work of healthcare providers.
The Mpilo Project has been thinking a lot about providers in the past few years, and candidly we didn’t start from a place of appreciation.
The Challenge
In research with more than 2,000 men in South Africa, many cited negative interactions with healthcare workers as a barrier to care. Men related experiences of harsh treatment in the clinic and generally characterized it as a disempowering and unsupportive space. We also identified various assumptions and misperceptions about men that can contribute to a provider-patient disconnect.
In building empathy with men, we may have inadvertently developed some bias against healthcare providers. So, it was a ‘lightbulb moment’ when providers told us that they often feel disempowered and unsupported in the clinic as well. Discouraged by provider-patient dynamics, many health workers hungry for insights and approaches that would lead to more fruitful and fulfilling interactions with patients, particularly men.
We can’t ignore the reality that we are losing some clients due to a negative clinic experience. But giving empathy to clients by withholding it from providers will not solve the problem. We need approaches that feel supportive rather than punitive.
The Solution
We’re currently piloting a person-centered care model called Ngiyakuzwa (“I hear you” in Zulu), based on the hypothesis that providers who feel supported will provide better support to clients.
The model employs on-the-job training, mentoring and coaching to help healthcare providers develop greater empathy and insight, from recognizing a man’s true emotional state ‘behind the mask’ to understanding how they are perceived by patients. It also focuses on helping them strengthen communication skills, manage stress, improve teamwork, and feel recognized and appreciated.
Because every relationship involves two parties, we are also thinking about how to help patients understand how they are perceived by providers, empathize with the pressures that providers face, and engage with providers in ways that improve the likelihood of a positive interaction.
We’ve only been piloting for a few months in partnership with a small number of facilities in KwaZulu-Natal Province. Still, clinic teams have engaged enthusiastically in design, planning and implementation. Their initial feedback is that the model speaks to their needs, preferences, and realities.
We look forward to sharing more on lessons and results as the pilot continues. For now, we want to take the opportunity to affirm healthcare providers as one group of people that we need to be centering on as we pursue person-centered care!
Funded by the Bill & Melinda Gates Foundation and led by PSI in partnership with Ipsos, Matchboxology and the South African Department of Health, the Mpilo project aims to increase linkage to HIV treatment and prevention among men in South Africa by designing, testing, and scaling interventions that are informed by an understanding of men’s barriers and preferences.
