I have contributed to healthcare in Kenya in many areas. I was a co-founder and first chairman of the doctors’ union (KMPDU). I participated in the development of the patient charter and the Health act 2017 amongst many initiatives. I pushed for and was a key player in the “Musyimi” task-force report on strengthening healthcare delivery in the public sector. However, of these achievements, the one that I single out for mention is the GIERAFS model.

Patients seek two things from health workers: healing and a sense of being heard and cared for. Patients want to attain cure and recover from their illnesses. However, they also want to be treated with respect and feel that they have been listened to. In fact, a quack with tremendous patience, humility, attention and an overdose of “compassion” is likely to get better reviews than a haughty doctor.

Client experience is an area of focus in private institutions. However, even here it remains a struggle. In our public facilities, there are those health workers who try to extend a positive experience, but their efforts are often drowned by an unsupportive, broken system or a majority who, for one reason or the other, do not try anymore.

In 2016, an administrative colleague of mine (Sr. Felistas King’ori, of the Sisters of Mercy Kenyan Province) and I shared a concern on this very matter. Then one morning in 2016, in my office at the Mater Misericordiae Hospital,  in a discussion with Sr. Felistas,, it occurred to me that perhaps the missing link was a set structure that would provide proper guidance to well meaning health workers.  As a result of this discussion and by the end of this one meeting,  the GIERAFS model had been born as a simple, easy to remember, easy to apply, yet effective model to guide the interaction between all health care workers and their clients.

GIERAFS is a mnemonic detailing the basic components, in sequential order, of an interaction between a healthcare worker and his/her patient:

G – Greet the patient

I – Introduce Yourself

E – Explain what you would like to do

R – Request the patient’s permission to proceed

A – Ask whether they have questions and answer any questions they may have

F- Feedback to the client on your findings and plan

S- Smile. It helps. 🙂

Please try it out and let me know how it works. Good luck.

Dr. Victor Ng’ani



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