Findings: Of 967 titles and 412 abstracts screened, 125 full-text papers were reviewed and 81 included. Around
two-thirds used qualitative methods and over half studied public-sector facilities. Most studies were in Africa
(n = 55), followed by Asia and the Pacific (n = 17). Fifty-eight studies covered only negative attitudes or behaviours, with
a minority describing positive provider behaviours, such as being caring, respectful, sympathetic and helpful. Negative
attitudes and behaviours commonly entailed verbal abuse (n = 45), rudeness such as ignoring or ridiculing patients
(n = 35), or neglect (n = 32). Studies also documented physical abuse towards women, absenteeism or unavailability
of providers, corruption, lack of regard for privacy, poor communication, unwillingness to accommodate traditional
practices, and authoritarian or frightening attitudes. These behaviours were influenced by provider workload, patients’
attitudes and behaviours, provider beliefs and prejudices, and feelings of superiority among MHCPs. Overall, negative
attitudes and behaviours undermined health care seeking and affected patient well-being.