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Many women experience gender-related sociocultural, physical, and financial barriers that constrain their ability to seek care.

Although family planning programs are paying more attention to men's and couples' roles as clients, most programs still deal primarily with women.

Gender and Discrimination Class, ethnicity, status, age, and gender all shape clients' experiences with family planning and reproductive health services.

Clients may fear disrespectful or discriminatory treatment.

Rumors and Myths Fears, rumors, and myths about family planning methods can prevent women from seeking services.

In one survey in Indonesia, clients believed that they could only get the truth about side effects from friends or relatives (Adongo et al. Rumors and myths about family planning may raise potential clients' concerns about the side effects, safety, and effectiveness of different methods.

Understanding clients' beliefs can help providers align their services with these ideas or, when necessary, address local misconceptions.

Issues affecting quality of care extend beyond the clinic setting, influencing clients before they arrive at the clinic.But the degree to which these barriers limit access is strongly influenced by clients' perception of quality.Distance Many women cannot easily get to clinics, which are often far apart.These client perceptions are in turn affected by personal, social, and cultural factors.Research highlights the benefits of addressing client perspectives on quality of care, since it leads to improved client satisfaction, continued and sustained use of services, and improved health outcomes (Bertrand et al. Clients' perspectives on quality affect their behavior both before and during the time of service.In Kenya, one study participant said that using oral contraceptives "can cause blood to flow out of the nose and mouth, and can cause delivery of children with two heads or no skin" (Rutenberg and Watkins 1997: 297).