Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania
Abstract Background There has been a persistent increase in clients’ dissatisfaction with providers’ competencies in maternal and child healthcare (MCH). Existing interventions have failed to address the complexity of provider-client relationships. Therefore, targeted, contextualized innovative solu...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Nursing |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12912-024-01808-0 |
| _version_ | 1797275291050049536 |
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| author | Kahabi Isangula Eunice S. Pallangyo Eunice Ndirangu-Mugo |
| author_facet | Kahabi Isangula Eunice S. Pallangyo Eunice Ndirangu-Mugo |
| author_sort | Kahabi Isangula |
| collection | DOAJ |
| description | Abstract Background There has been a persistent increase in clients’ dissatisfaction with providers’ competencies in maternal and child healthcare (MCH). Existing interventions have failed to address the complexity of provider-client relationships. Therefore, targeted, contextualized innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation are needed. The study team adopted a co-design strategy as part of Human- Centered Design (HCD) approach, where MCH nurses, clients, and stakeholders partnered to design an intervention package to improve provider-client relationships in rural Tanzania. Objective This paper explored nurses’, clients’, and MCH stakeholders’ perspectives following participation in a co-design stage of the HCD study to generate interventions to strengthen nurse-client relationships in Shinyanga Region. Methods A qualitative descriptive design was used. Thirty semi-structured key informant interviews were conducted in the Swahili language with purposefully selected nurses, clients, and MCH stakeholders. The inclusion criterion was participation in consultative workshops to co-design an intervention package to strengthen nurse-client relationships. Data were transcribed and translated simultaneously, managed using NVivo, and analyzed thematically. Results Three main themes were developed from the analysis, encompassing key learnings from engagement in the co-design process, the potential benefits of co-designing interventions, and co-designing as a tool for behavior change and personal commitment. The key learnings from participation in the co-design process included the acknowledgment that both nurses and clients contributed to tensions within their relationships. Additionally, it was recognized that the benefits of a good nurse-client relationship extend beyond nurses and clients to the health sector. Furthermore, it was learned that improving nurse-client relationships requires interventions targeting nurses, clients, and the health sector. Co-designing was considered beneficial as it offers a promising strategy for designing effective and impactful solutions for addressing many challenges facing the health sector beyond interpersonal relationships. This is because co-designing is regarded as innovative, simple, and friendly, bringing together parties and end-users impacted by the problem to generate feasible and acceptable interventions that contribute to enhanced satisfaction. Furthermore, co-designing was described as facilitating the co-learning of new skills and knowledge among participants. Additionally, co-designing was regarded as a tool for behavior change and personal commitment, influencing changes in participants’ own behaviors and cementing a commitment to change their practices even before the implementation of the generated solutions. Conclusion End-users’ perspectives after engagement in the co-design process suggest it provides a novel entry point for strengthening provider-client relationships and addressing other health sector challenges. Researchers and interventionists should consider embracing co-design and the HCD approach in general to address health service delivery challenges. |
| first_indexed | 2024-03-07T15:12:09Z |
| format | Article |
| id | doaj.art-8dc6a752ecb14ab180da7ce25dbd9fef |
| institution | Directory Open Access Journal |
| issn | 1472-6955 |
| language | English |
| last_indexed | 2024-03-07T15:12:09Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nursing |
| spelling | doaj.art-8dc6a752ecb14ab180da7ce25dbd9fef2024-03-05T18:36:22ZengBMCBMC Nursing1472-69552024-03-0123111110.1186/s12912-024-01808-0Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural TanzaniaKahabi Isangula0Eunice S. Pallangyo1Eunice Ndirangu-Mugo2School of Nursing and Midwifery, The Aga Khan UniversitySchool of Nursing and Midwifery, The Aga Khan UniversitySchool of Nursing and Midwifery, The Aga Khan UniversityAbstract Background There has been a persistent increase in clients’ dissatisfaction with providers’ competencies in maternal and child healthcare (MCH). Existing interventions have failed to address the complexity of provider-client relationships. Therefore, targeted, contextualized innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation are needed. The study team adopted a co-design strategy as part of Human- Centered Design (HCD) approach, where MCH nurses, clients, and stakeholders partnered to design an intervention package to improve provider-client relationships in rural Tanzania. Objective This paper explored nurses’, clients’, and MCH stakeholders’ perspectives following participation in a co-design stage of the HCD study to generate interventions to strengthen nurse-client relationships in Shinyanga Region. Methods A qualitative descriptive design was used. Thirty semi-structured key informant interviews were conducted in the Swahili language with purposefully selected nurses, clients, and MCH stakeholders. The inclusion criterion was participation in consultative workshops to co-design an intervention package to strengthen nurse-client relationships. Data were transcribed and translated simultaneously, managed using NVivo, and analyzed thematically. Results Three main themes were developed from the analysis, encompassing key learnings from engagement in the co-design process, the potential benefits of co-designing interventions, and co-designing as a tool for behavior change and personal commitment. The key learnings from participation in the co-design process included the acknowledgment that both nurses and clients contributed to tensions within their relationships. Additionally, it was recognized that the benefits of a good nurse-client relationship extend beyond nurses and clients to the health sector. Furthermore, it was learned that improving nurse-client relationships requires interventions targeting nurses, clients, and the health sector. Co-designing was considered beneficial as it offers a promising strategy for designing effective and impactful solutions for addressing many challenges facing the health sector beyond interpersonal relationships. This is because co-designing is regarded as innovative, simple, and friendly, bringing together parties and end-users impacted by the problem to generate feasible and acceptable interventions that contribute to enhanced satisfaction. Furthermore, co-designing was described as facilitating the co-learning of new skills and knowledge among participants. Additionally, co-designing was regarded as a tool for behavior change and personal commitment, influencing changes in participants’ own behaviors and cementing a commitment to change their practices even before the implementation of the generated solutions. Conclusion End-users’ perspectives after engagement in the co-design process suggest it provides a novel entry point for strengthening provider-client relationships and addressing other health sector challenges. Researchers and interventionists should consider embracing co-design and the HCD approach in general to address health service delivery challenges.https://doi.org/10.1186/s12912-024-01808-0User centred-designDesign thinkingUser participationProvider-patient relationships |
| spellingShingle | Kahabi Isangula Eunice S. Pallangyo Eunice Ndirangu-Mugo Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania BMC Nursing User centred-design Design thinking User participation Provider-patient relationships |
| title | Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania |
| title_full | Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania |
| title_fullStr | Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania |
| title_full_unstemmed | Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania |
| title_short | Nurses’ and clients’ perspectives after engagement in the co-designing of solutions to improve provider-client relationships in maternal and child healthcare: a human-centered design study in rural Tanzania |
| title_sort | nurses and clients perspectives after engagement in the co designing of solutions to improve provider client relationships in maternal and child healthcare a human centered design study in rural tanzania |
| topic | User centred-design Design thinking User participation Provider-patient relationships |
| url | https://doi.org/10.1186/s12912-024-01808-0 |
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