Nurturing hope in Rwandan healthcare settings: Exploring factors that influence hope among healthcare providers, pregnant women, and mothers with children under five years.

According to the World Health Organization, inadequate antenatal care increases risks for both mothers and children, many of which can be prevented through regular screening, timely treatment, and adoption of healthy behaviors. Evidence suggests that healthcare recipients (HCRs) who receive quality care tend to be more hopeful and engaged in their care, while hope among healthcare providers (HCPs) can reduce burnout and enhance their ability to deliver quality services. This study explores the role of hope in healthcare delivery among HCRs and HCPs in rural Northern Rwanda, focusing on three key dimensions of hope: interconnectedness, readiness for change, and future orientation. Using a qualitative design, the research draws on focus group discussions and key informant interviews. Thematic analysis was conducted to identify key factors influencing hope and to generate recommendations for embedding hope in healthcare at individual, interpersonal, and health system levels. The analysis mapped a quadruple of areas serving as both facilitators and barriers of hope; relationships, care experiences, continuous learning, and working conditions. Respectful communication by HCPs fostered trust and positively influenced HCRs' engagement. Faith, learning opportunities, and positive health system encounters supported future orientation and confidence. While HCPs showed strong commitment to care, their motivation was often challenged by resource constraints and poor working environments. The study highlights the importance of aligning quality care strategies with factors that promote hope. Strengthening relational care, promoting continuous learning, and improving work conditions can foster a more hopeful and resilient health system. Prioritizing such approaches can enhance both patient engagement and provider well-being across primary care settings.