“Smart patient and smart community”: An evaluation of multiple interventions to enhance patient participation in Indonesia

This study evaluated “Smart Patient and Smart Community” interventions that aimed to enhance patient participation in family planning consultations in Indonesia. Community outreach health services conducted group education sessions to encourage women to prepare questions before seeing a provider and to ask questions during consultations. A specially designed, illustrated, low-literacy checklist of common concerns (called a “Smart Patient Card”) was also distributed at the sessions and made available in clinic waiting areas. During the same time period, television and radio spots and posters promoted the image of practitioners as a “Sahabat,” or special friend.

The study was conducted in two villages in the Sukabumi district of West Java province. Of 800 women interviewed at home, 565 had visited clinics for family planning services during the intervention period. Compared with patients who did not receive a “Smart Patient Card,” patients who had the card were more likely to prepare questions before seeing a provider (69% vs. 32%, p<.001) and to ask most of their questions (50% vs. 13%). Patients who were exposed to more mass-media communication were more likely to prepare (79% vs. 43%, p<.001) and ask questions (53% vs. 36%, p<.01) than those exposed to less media.

Community education that encourages patients to prepare questions before seeing providers can help raise the level of patient participation.