Table 2.

Quotes illustrating disrespectful care in family planning service provision; data collected via family planning mystery client and third-party observations, Western Kenya, 2019

Theme	Data Source	Illustrative quote
SCORNFUL TREATMENT	Mystery client reports	“The provider laughed at me when she asked me if I have children and I said I don’t have children, then she laughed at me saying that she wonders what is wrong with people who don’t have children, but they need family planning.” “The provider wanted me to prove that am not pregnant by going for a lab test and when I assured her that I am not pregnant she sneered at me and looked at me badly.”
	Third-party observations	“The provider told the client that she was too young to have a co-wife. She went ahead to ask what the client did that made the husband to marry a second wife.” “She said the client have added weight like a pig.” “The provider scorned the client by telling her she had 5 kids and she was still considering injectable instead of Tubal ligation.” “The provider told the client that, even though she is 19 years old, she should wait to get married first is when she should start using family planning especially her current method that is injectable. The provider again asked the client with a lot of pettiness if she is jumpy jumpy lady who moves from one man to the other.”
SCOLDING OR SHOUTING	Mystery client reports	“I told the provider that I was visiting my sister within that village after which he made a comment that I came to look for men that’s why I wanted family planning so that I don’t get pregnant.” “The nurse said she didn’t see the essence of a young lady who is single taking pills instead of abstaining.” “I went to ask about registration procedure, but she was harsh and told me that they don’t talk to people through the window and commanded me to go sit down.”
	Third-party observations	“When the provider asked for the clients phone number for their own records, the client told her to give her time to check the number from her phone then the provider shouted at her that she should know her number offhand or perhaps the number she is looking for from her phone is not hers.” “The provider was seemingly annoyed at something during this session, and he had so little patience for this client. At one point he asked her age, and she didn’t hear him well, he went ahead and angrily raised his voice at her saying that she needed to answer fast as there were other clients waiting.” “The provider told the client in a high tone that she should not complain about the injectable because she was told to come back when the side effects she has been complaining about persisted and she never came back.” “When the client told the provider that she was denied injectable in one of the facilities in Kisumu town because they don’t encourage it, the provider scolded her by telling her that maybe she never followed the instructions in that facility and even them they can deny her injectable especially when the right choice is made by the provider and the client insist on her choice.” “The provider told the client that small, small women are not straightforward especially someone like the client who gave birth 10 months ago and did not think of coming for family planning after six weeks.”
WITHHOLDING FAMILY PLANNING	Third-party observations	“The client did not have money to pay for the implant, the provider sternly told her that next time she should come with the cash or risk not being given her method of choice.” “The provider threatened to withdraw the service because the client come late for the service.”