ABSTRACT
Quality of health services is an important factor in terms of health care access. Access encompasses a range of dimensions spanning availability (e.g., geographic distribution of health facilities, etc.), accessibility (transport, etc.), affordability (user fees, etc.), and acceptability (referring to the social and cultural distance between health care systems and their users) (Hausmann-Muela et al., 2003). This aspect of analysis recognizes that even if patients do reach health services, and do get to see a health care provider, they will not necessarily be able to access good quality care because of problems with the provider-patient relationship. This dimension of access signifi es an important shift away from narrowly defi ning quality of services in terms of technical and clinical competence towards a broader defi nition that acknowledges the importance of the quality of interpersonal communication between providers and patients as an importance barrier to access. In this chapter, we defi ne the patient-provider interaction as one that occurs between a patient and a health service provider. Although we recognize the important role that non-biomedical healers play in meeting the health needs of large sectors of the population, we will not be dealing with interactions between them and patients in this chapter.
