How should CHWs respond to a client who refuses services?

• A. Respect autonomy, document reasons, provide information briefly, offer to revisit later, and respect the client's decision.
• B. Coerce them to accept services.
• C. Ignore their decision.
• D. Shame them for refusing.

Answer: (A)

Respecting a client’s autonomy is the core approach when they refuse services. The best response is to acknowledge their decision, respect their right to choose, share essential information briefly so they have what they need to decide, and offer to revisit the conversation later. Documenting the reasons they gave helps you understand potential barriers and informs future outreach, without pressuring the client. This keeps the trust and rapport essential to effective CHW work and preserves the client’s sense of control over their own care.

Coercion undermines trust and can cross ethical or policy boundaries; ignoring the decision disrespects the client and can endanger the relationship and care; shaming the client damages dignity and can drive them away from seeking help in the future. A concise, respectful invitation to revisit the topic whenever they’re ready maintains support while honoring their choice.