Building trust is essential
for high-quality sustainable services

The JICA RH Project Phase II in Nghe An Province, Vietnam, came to an end in August 2005, and from 27th June to 22nd July, the final technical training for project personnel was held in Japan. A midwife and two assistant doctors from the MCH/FP Center, Nghe An, the core facility of the RH project, and an obgyn doctor from the District Health Center took part in lectures, technical training and discussions in Tokyo and around the country.

The training focused on four key areas:

1 Upgrading skills in:

Pregnancy an obstetric care
Client-friendly communication skills
Privacy Breast massage and feeding
Allowing women to choose their delivery position
Newborn care

Posture and standing position of the health personnel
is very important to personify the "Respect" to the clients
(at Adachi Hospital)

2 Education of pregnant women and their partners, including:

Parenting classes
Guidance in hospital
Post-delivery
Counseling, including post-abortion
Health checks

Impressed to know that health provider
and clients can share thoughts and same emotion
(at Ayumi Maternity Hospital)

3 Management of pregnancy care, including:

Group health checks
Infant health checks
Use of the MCH handbook

Observed that "Manual" for health personnel works
for client friendly service upon conducting
mass health checkups (at Chofu City Health Center)

4 Other related RH areas, such as:

ASRH
Use of IEC
Learning about the community-operated health experience of Japan

After the "Action Plan" presentation together
with the (Vietnam project support experts group?)

In March 2005, previous trainees met to decide what information following trainees needed to acquire, and the training took this into account. In addition, both short- and long-term experts gave input into the training curriculum.

Action Plan

By the end of the training, the Vietnamese participants developed an action plan, based on their experiences in Japan. They determined that the key element in client services was "Building trust relationships."

Why trust?

• RH is a very sensitive topic
• With trust, more clients will come to get services
• Providers can deliver more care to an adequate client base
• Clients will then gain knowledge, leading to behavior change
• Clients will then improve their RH condition

How to build trust? The three "Rs"

• RELAX clients
• RESPECT clients
• RESPOND to clients needs

Elements to relax clients

Proper greeting Smile
Introduce self
Sit nearby
Do not take notes while talking
Look into the eyes
Speak calmly
Do not be superior
Listen carefully
Show empathy

Elements to respect clients

Ask permission
Do not be judgmental
Do not alarm clients Fully explain procedures before commencing
Ensure privacy

Elements to respond to clients needs

Ask questions
Explain in detail Use easy to follow language
Use IEC to facilitate explanation
Listen to clients' opinions
Ensure level of own education
Ensure safe and hygienic services
Clearly show service costs

Other areas that were covered included: appropriate questioning during counseling, such as for post-abortion care; improving parenting classes; breast massage technique; using IEC; and making a photo album of happy mothers and babies delivered at the clinic so that new clients would feel more at ease.

As a part of the action plan, a manual will be developed based on "How to build trust through the three "Rs" to be used at the MCH/FP center and the district health center.

The Vietnamese counterparts also stressed that they would always keep in mind what they had learned in Japan in order that they may keep improving their skills.