Table 1.

Questions used to develop indicators of disrespectful care

Construct	Indicator	Questions from qualitative tool used to create indicator
Domain: Refusal of care
Refusal of services due to non-essential procedures	% of visits where the SCs did not receive method due to refusal of HIV test, TT vaccination or clinic was closed when it was supposed to be open	• Were you prescribed, given or referred for a method during this visit? • If no, referred to field notes for reason.
Domain: Non-private consultation
Client services are not provided with visual or auditory privacy	% of visits that took place in a group setting, or without visual and auditory privacy	• Did the provider talk to you about your family planning methods in a group or by yourself? • If individual counseling, was the consultation conducted in an area where no one could see you and provider? • If individual counseling, was the consultation conducted in an area where no one could hear your conversation?
Domain: Poor client-centered care
Incomplete family planning options given by provider(s)	% of visits where the provider did not mention any methods beyond what the SC requested (pills)	• Did the provider talk to you (or the group) about any contraceptive methods? • If yes, what contraceptive method(s) did the provider talk with you about?
Inaccurate information by provider(s)	Not measured through quantitative tool.
Client unsupported in personal method choice	% of visits where the provider advocated for a method	• Did the provider talk to you (or the group) about any contraceptive methods? • If yes, do you feel the provider advocated a specific method for you during the consultation?
	% of visits where the provider did not ask client preference	• Did the provider talk to you (or the group) about any contraceptive methods? • If yes, did the provider ask you about your preference in contraceptive methods?
Poor listening and attention by provider(s)	% of visits where the provider did not greet SCs (or the group) respectfully	• Did the provider greet you (or the group) respectfully?
	% of visits where the provider interrupted the SCs while speaking or interrupted consultation for other business	• Did the provider interrupt you while you were speaking? • Did the provider interrupt the consultation to conduct other business?
Domain: Non-dignified care
Clients experience humiliating treatment from providers or other health staff	% of visits where the provider SCs experienced humiliating treatment such as yelling, threatening, scolding, or being insulted	• Did provider raise their voice or yell at you? • Did provider use a disparaging term to describe you? • Did provider do anything else considered disrespectful or abusive? • If yes, what did the provider say or do? • Did the provider make any critical or judgmental comments about: • The number of children you have? Or do not have? • Your plans for whether you want to have more children and when? • Your partner/marital status? • The involvement of your partner in your family planning? • Your sexual activity? • The involvement of your parents? • Your age in regards to accessing family planning? • Your preferred method of contraceptives? • Your physical appearance? Judgement comments by staff • At any point, did you feel unwelcome by other health facility staff? • At any point, did other health facility staff make disrespectful or judgmental remarks to you or about you to others where you could overhear? • If yes, what did the staff say or do?
Clinic level barriers to care	% of visits where the SCs waited longer than one hour for services	• How long did you wait to be seen?
	% of visits where the provider asked for additional money (informal payments)	• Did provider ask for additional money (informal payment)? • Did any other health facility staff ask you for additional money (informal payment)?