What is it about?
This study explores how hope influences healthcare for both providers (HCPs) and recipients (HCRs) in rural Rwanda. We defined hope through three dimensions: interconnectedness, readiness for change, and future orientation, and examined these through focus groups and interviews. To guide the analysis, we employed three frameworks: the COM-B model, which examines how capability, opportunity, and motivation shape providers’ behavior; the Health Belief Model, which explores how patients’ perceptions and motivations influence engagement; and the Socioecological Model, to draw individual, interpersonal and health system norms that influence hope. Together, these helped us capture the emotional, behavioral, and structural drivers of hope. Our findings show that hope strengthens patient engagement, improves communication, and supports providers in delivering compassionate care. We conclude that incorporating patients’ experiences and sustaining providers’ hope are essential for building high-quality healthcare systems.
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Why is it important?
While the link between hope and well-being is well recognized, little research has documented the specific factors that foster hope within healthcare settings. This gap matters because hopeful providers are more likely to build strong, trusting relationships with their patients, and hopeful patients are more likely to stay engaged in care. Our study contributes to the literature by showing a cyclical process: when HCPs sustain hope, they deliver more effective and compassionate care, which in turn empowers their HCRs to continue engaging with health services. In Rwanda, where maternal and child health outcomes have improved dramatically over the past three decades, understanding and reinforcing the role of hope is particularly important to sustain these gains. By identifying the emotional, behavioral, and system-level drivers of hope, this research provides new insights into how to strengthen both provider commitment and patient engagement in maternal and child healthcare.
Perspectives
Hope is a central element of high-quality care, extending well beyond its traditional association with palliative settings. In our study, providers themselves were struck by seeing hope framed more broadly, which underscored for me how vital it is to nurture their sense of agency and accomplishment alongside meeting patient expectations. A particularly telling insight was that, while providers were genuinely enthusiastic about initiatives to improve patient care and open to embracing change, many voiced discouragement when reforms failed to address the challenges of their daily work or when progress in patient outcomes was slow. For me, this highlights that health system strategies must go beyond focusing solely on patient experience; they must also reinforce provider capacity and wellbeing, creating conditions in which both patients and providers can participate meaningfully in the healthcare journey.
Angele Bienvenue Ishimwe
TIP Global Health
Read the Original
This page is a summary of: Nurturing hope in Rwandan healthcare settings: Exploring factors that influence hope among healthcare providers, pregnant women, and mothers with children under five years, PLOS Global Public Health, August 2025, PLOS,
DOI: 10.1371/journal.pgph.0005095.
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