scholarly journals Patients’ Satisfaction with HIV Care Providers in Public Health Facilities in Lusaka: A Study of Patients who were Lost-to-Follow-Up from HIV Care and Treatment

2019 ◽  
Vol 24 (4) ◽  
pp. 1151-1160
Author(s):  
Njekwa Mukamba ◽  
Obvious N. Chilyabanyama ◽  
Laura K. Beres ◽  
Sandra Simbeza ◽  
Kombatende Sikombe ◽  
...  

Abstract Prognosis among those who are HIV infected has improved but long-term retention is challenging. Health systems may benefit from routinely measuring patient satisfaction which is a potential driver of engagement in HIV care, but it is not often measured in Africa, and Zambia in particular. This study aims to internally validate a patient satisfaction tool, assess satisfaction among patients previously lost-to-follow up (LTFU) from HIV care in Lusaka province and to measure association between patient satisfaction with their original clinic and re-engagement in HIV care. A cross-sectional assessment of satisfaction was conducted by tracing sampled patients drawn from public health facilities. Our findings suggest that satisfaction tool, previously validated in USA, exhibits high internal consistency for measuring patient satisfaction in the Zambian health system. Patient satisfaction with healthcare providers is associated with re-engagement in HIV care. Future interventions on patient-centred care are likely to optimize and support retention in care.

2019 ◽  
Author(s):  
Gizachew Worku Dagnew ◽  
Yared Mulu Gelaw ◽  
Melash Belachew Asresie ◽  
Zelalem Alamrew Anteneh

Abstract Abstract Background: Implanon discontinuation is unacceptably high in developing countries, including Ethiopia; furthermore there is an observed problem of high unintended pregnancy rate after method discontinuation this might stride to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Adabet district, public health facilities, North-West Ethiopia, 2017. Methods: Facility-based cross-sectional study was conducted among 537 women, from Feb.03 to April 28, 2017, by face to face interview. Systematic random sampling technique was used to select the study subjects. The collected data were entered into Epi Info- version 7 then exported to SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multi-variable binary logistics regression, p-value and odds ratio (AOR) with 95%Ci was used to showing statistical association with the outcome variable. Results: In this study, 36.9% of Implanon users were discontinued the method before the intended time period. Among those women who discontinue the method 85.9% of them were discontinued before two years of Implanon insertion. Women who had no live child at the time of Implanon insertion[AOR=2.17,95%CI:1.25-3.77], didn’t received pre-insertion counseling on potential side effects [AOR=1.85,95%CI: 1.15-2.97], developed side effect secondary to Implanon insertion [AOR=5.17,95%CI:3.18-8.40], received appointment follow-up [AOR=0.23,95%CI:0.13-0.41], and not satisfied by the service provided [AOR=5.40,95%CI:3.04-9.57] were statistically associated with Implanon discontinuation. Conclusions: level of Implanon discontinuation before its intended period was high. Hence, to increase Implanon continuation rate; provide pre-insertion counseling including its possible side effects, improve client’s service satisfaction and strength appointment follow-up for Implanon users should be made.


2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Tewodros Seyoum ◽  
Mekuriaw Alemayehu ◽  
Kyllike Christensson ◽  
Helena Lindgren

BACKGROUND፡ Timely entry to an antenatal care with a healthcare provider who follows a set of national guidelines is assumed to ensure higher levels of client satisfaction. It is also expected to improve perinatal outcomes. Little is known about the level of adherence of Ethiopian providers to these guidelines. Therefore, this study aims to assess the proportion of clients who received complete (100%) provider adherence to antenatal care guidelines at the first visit and client associated factors in Gondar Town.METHODS: A cross-sectional study of 834 study participants was conducted in public health facilities of Gondar Town in Ethiopia. An 18 point checklist was used to observe provider adherence to the first antenatal care visit guidelines. Descriptive statistics and multivariable binary logistic regression model were done by using STATA 14 software.RESULT: The proportion of clients who received the complete provider’s adherence to the first antenatal care guideline was 32.25% (95% CI: 29.1-35.5). The mean adherence score was 16.78%. Women who had prior history of pregnancy and/or birthrelated complications (AOR = 1.58; 95%CI: 1.04-2.04) and late antenatal care booking at gestational week 16 or greater (AOR =1.45; 95%CI: 1.03-2.03) were significantly associated with clients receiving complete providers’ adherence to the first antenatal guideline.CONCLUSIONS: We found the level of adherence to national antenatal care guidelines during first visit as surprisingly low. When considering to upgrade the guidelines to the actual WHO guideline of eight visits, we recommend that refresher training be provided regularly to help staff understand the importance of following the guidelines as closely as possible. Perhaps, we need to learn more from the health care providers themselves about their reasons for not following the guidelines.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Gizachew Worku Dagnew ◽  
Yared Mulu Gelaw ◽  
Melash Belachew Asresie ◽  
Zelalem Alamrew Anteneh

Background. Implanon discontinuation is unacceptably high in developing countries, including Ethiopia. Furthermore, there is an observed problem of high unintended pregnancy after method discontinuation that strides to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Andabet district, public health facilities, North-West Ethiopia, 2017. Methods. Facility-based cross-sectional study design was employed among 537 women from Feb. 03 to April 28, 2017. Study participants were selected using a systematic random sampling technique. A face-to-face interview was employed to collect data. Epi-Info version 7 was used for data entry and SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multivariable binary logistic regression, a p value of less than 0.05 was used to declare statistical significance. Results. About 37% of Implanon users have discontinued the method before the intended time. About 86% of them discontinued Implanon before two years of insertion. Women who had no live child ( AOR = 2.17 , 95% CI: 1.25-3.77), women who did not receive preinsertion counseling ( AOR = 1.85 , 95% CI: 1.15-2.97), women who developed Implanon-related side effect ( AOR = 5.17 , 95% CI: 3.18-8.40), and women who did not satisfy by the service provided ( AOR = 5.40 , 95% CI: 3.04-9.57) had higher odds of Implanon discontinuation. On the other hand, women who received appointment follow-up ( AOR = 0.23 , 95% CI: 0.13-0.41) had lower odds of Implanon discontinuation. Conclusions. The level of Implanon discontinuation before its intended time was high in the district. Hence, strengthening preinsertion counseling and appointment follow-up as well as improving the clients’ level of service satisfaction could increase Implanon’s continuation.


2020 ◽  
Author(s):  
Gizachew Worku Dagnew ◽  
Melash Belachew Asresie

Abstract Background: Implanon discontinuation is unacceptably high in developing countries, including Ethiopia. Furthermore, there is an observed problem of high unintended pregnancy after method discontinuation that stride to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Andabet district, public health facilities, North-West Ethiopia, 2017.Methods: Facility-based cross-sectional study design was employed among 537 women from Feb.03 to April 28, 2017. Study participants were selected using a systematic random sampling technique. A face-to-face interview was employed to collect data. Epi Info- version-7 was used for data entry and SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multi-variable binary logistics regression, a p-value of less than 0.05 was used to declare statistical significance.Results: About 37% of Implanon users have discontinued the method before the intended time. Of about 86% of them were discontinued Implanon before two years of insertion. Women who had no live child [AOR=2.17,95%CI:1.25-3.77], women who didn’t receive pre-insertion counseling [AOR=1.85,95%CI:1.15-2.97], women who developed Implanon related side effect [AOR=5.17,95%CI:3.18-8.40], and women who did not satisfy by the service provided [AOR=5.40,95%CI:3.04-9.57] had higher odds of Implanon discontinuation. On the other hand, women who received appointment follow-up [AOR=0.23,95%CI:0.13-0.41] had lower odds of Implanon discontinuation.Conclusions: The level of Implanon discontinuation before its intended time was high in the district. Hence, strengthening pre-insertion counseling and appointment follow-up as well as improving the client’s level of service satisfaction may increase Implanon continuation.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.


2022 ◽  
Vol 5 (1) ◽  
pp. 01-08
Author(s):  
Melaku Wolde Anshebo ◽  
Tesfaye Gobeana Tessema ◽  
Yosef Haile Gebremariam

Background: There is paucity of information on level of commitment among health professionals attending delivery service in public health facilities of low-income countries including Ethiopia. Hence, the aim of this study is to assess the level and factors associated with professional commitment among institutional delivery services providers at public health facilities in Shone District, Southern Ethiopia. Methods: A facility-based cross-sectional study design was conducted at primary level public health facilities in Shone District. All health facilities (one primary hospital and 7 health centers) were included in the study. Five hundred three study participants who fulfilled inclusion criteria in proportion to obstetric care providers in each public health facilities were selected by applying simple random sampling method. Self-administered Likert scale type of questionnaire was used. Data were analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were done to see the association between dependent and explanatory variables. Results: The magnitude of professional commitment for obstetric care providers working in public health facilities of Shone district was 69.4%. In this study, those who worked at hospital, those who had positive attitude toward organizational commitment, and those who had positive attitude toward personal characteristics were 2.4, 2.3 and 1.76 times more likely committed to profession compared with their counterparts respectively. Conclusion: The professional commitment among institutional delivery service provision was medium as compared to other study finding. All health professional should manage their own personal characteristics to behave in good way to be committed for their profession. Organizational commitment had great influence on professional commitment.


2020 ◽  
Vol 14 (01) ◽  
pp. 18-27 ◽  
Author(s):  
Anant Nepal ◽  
Delia Hendrie ◽  
Suzanne Robinson ◽  
Linda A Selvey

Introduction: Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. Little is known about antibiotic prescribing practices at public health facilities in low- and middle-income countries. We examined patterns of antibiotic prescribing in public health facilities in Nepal and explored factors influencing these practices. Methodology: A cross-sectional study of antibiotic prescribing in public health facilities was conducted in the Rupandehi district of Nepal. Six public health facilities were selected based on WHO guidelines, and data were extracted from administrative records for 6,860 patient encounters. Patterns of antibiotic prescribing were investigated using descriptive statistics. Chi-squared tests and logistic regressions were applied to explore factors associated with antibiotic prescribing. Results: Of patients attending public health facilities, the proportion prescribed at least one antibiotic (44.7%) was approximately twice the WHO recommended value (20.0 to 26.8%). The antibiotic prescribing rate for hospital inpatients (64.6%) was higher than for other facilities, with the prescribing rate also high in primary health care centres (50.4%) and health posts (52.2%). The most frequently (29.9%) prescribed antibiotic classes were third-generation cephalosporins. Females (p = 0.005) and younger (p < 0.001) patients were more likely to be prescribed antibiotics. High prescribing rates of antibiotics for selected diseases appeared contrary to international recommendations. Conclusion: Antibiotic prescribing in public health facilities was high compared with WHO guidelines, suggesting the need for strategies to reduce misuse of antibiotics. This study provides useful information to assist in formulating policies and guidelines to promote more appropriate use of antibiotics in Nepal.


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