scholarly journals Outsiders, insiders, and intermediaries: village health teams’ negotiation of roles to provide high quality sexual, reproductive and HIV care in Nakaseke, Uganda

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samantha Perry ◽  
Cynthia D. Fair ◽  
Sahai Burrowes ◽  
Sarah Jane Holcombe ◽  
Robert Kalyesubula
Keyword(s):  
Hiv Care ◽  
High Quality ◽  
Village Health ◽  
Village Health Teams

scholarly journals Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya

2019 ◽  
Vol 18 ◽  
pp. 232595821882328 ◽  
Author(s):  
Becky Genberg ◽  
Juddy Wachira ◽  
Catherine Kafu ◽  
Ira Wilson ◽  
Beatrice Koech ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Working Environment ◽  
Health System Strengthening ◽  
Eastern Africa ◽  
Hiv Care ◽  
Care Providers ◽  
High Quality ◽  
Western Kenya ◽  
System Factors

The burden on health systems due to increased volume of patients with HIV continues to rapidly increase. The goal of this study was to examine the experiences of HIV care providers in a high patient volume HIV treatment and care program in eastern Africa. Sixty care providers within the Academic Model Providing Access to Healthcare program in western Kenya were recruited into this qualitative study. We conducted in-depth interviews focused on providers’ perspectives on health system factors that impact patient engagement in HIV care. Results from thematic analysis demonstrated that providers perceive a work environment that constrained their ability to deliver high-quality HIV care and encouraged negative patient–provider relationships. Providers described their roles as high strain, low control, and low support. Health system strengthening must include efforts to improve the working environment and easing burden of care providers tasked with delivering antiretroviral therapy to increasing numbers of patients in resource-constrained settings.

scholarly journals National Survey of US HIV Clinicians: Knowledge and Attitudes About the Affordable Care Act and Opinions of its Impact on Quality of Care and Barriers to Care

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Kathleen A McManus ◽  
Joshua Ferey ◽  
Elizabeth Farrell ◽  
Rebecca Dillingham
Keyword(s):  
Quality Care ◽  
Binary Logistic Regression ◽  
The United States ◽  
Hiv Care ◽  
Medicaid Expansion ◽  
High Quality ◽  
High Quality Care ◽  
Knowledge And Attitudes ◽  
Hiv Epidemic

Abstract Background The Affordable Care Act’s (ACA’s) major reforms started in 2014. In addition to assessing HIV clinicians’ ACA knowledge and attitudes, this study aims to evaluate HIV clinicians’ perspectives on whether the ACA has impacted the quality of HIV care and whether it addresses the main barriers to HIV care. Methods HIV clinicians were emailed a survey weblink in 2018. Descriptive statistics, Mann-Whitney U tests, and binary logistic regression were performed. Results Of the 211 survey participants, the majority (70%) answered all 4 knowledge questions correctly. About 80% knew correctly whether their state had expanded Medicaid. Participants from Medicaid expansion states were more likely to report an improved ability to provide high-quality care compared with participants from Medicaid nonexpansion states (50% vs 34%; P = .01). The average response to whether the ACA addresses the main barriers to HIV care was neutral and did not differ based on Medicaid status. The top 3 main barriers to HIV care cited were mental health, substance use, and transportation. Conclusions HIV clinicians in Medicaid expansion states were more likely to report an improved ability to provide high-quality care since ACA implementation compared with those in Medicaid nonexpansion states. However, HIV clinicians across the United States are concerned that the ACA does not address the main barriers to HIV care. To be successful, the “Ending the HIV Epidemic” initiative should address these identified barriers.

scholarly journals Integrating Family Planning and HIV Services at the Community Level: Formative Assessment with Village Health Teams in Uganda

2017 ◽  
Vol 21 (2) ◽  
pp. 73-80 ◽  
Author(s):  
Aurélie Brunie ◽  
Patricia N. W. Mucheri ◽  
Angela Akol ◽  
Mario Chen ◽  
Sarah J Mercer ◽  
...  
Keyword(s):  
Family Planning ◽  
Formative Assessment ◽  
Community Level ◽  
Hiv Services ◽  
Village Health ◽  
Village Health Teams

scholarly journals Community overview on the differential prevalence of Hepatitis E in two Sub Counties in Kitgum District: A qualitative study

2021 ◽  
Author(s):  
Judith Aloyo ◽  
Juliet Kiguli ◽  
Christopher Orach Garimoi ◽  
David Lagoro Kitara
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Hepatitis E ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Community Control ◽  
Community Members ◽  
And Control ◽  
Village Health ◽  
Village Health Teams

Abstract Background There was an epidemic of Hepatitis E infection in Kitgum District in 2007. More than 10,422 people were infected, and over 166 deaths were registered due to the Hepatitis E virus. Kitgum District Health Management Information Systems (HMIS) showed that Hepatitis E cases continued to occur more in Mucwini than Kitgum Matidi Sub County despite instituting similar epidemic control measures in the two communities. The tenacity of the virus in Mucwini Sub County had remained unclear. Objective To assess communities’ views and perspectives on the differential prevalence of Hepatitis E in the two Sub Counties of Kitgum Matidi and Mucwini in Northern Uganda. Methods A cross-sectional study using qualitative methods was conducted. Four Focus Group discussions and six key informant interviews were conducted with village health teams, local council chairpersons, health workers, and community members. These persons were chosen purposively because of their expertise and experience in community and health services. Face-to-face interview guides were administered to obtain detailed information on factors associated with the differential occurrence of Hepatitis E in the two Sub Counties. This study was approved by a local IRB and Uganda National Council of Science and Technology (UNCS&T). Results The most significant findings from this study were the differences in prevention and control practices in the two communities. Residents of Mucwini were less compliant to infection, prevention, and control guidelines, and disagreements between local councilors and village health teams in Mucwini led to poor implementation and non-adherence to guidelines on community control of Hepatitis E. Conclusion A differentially higher prevalence of Hepatitis E in Mucwini than Kitgum Matidi Sub County resulted from poor personal and community hygiene and non-adherence to behavior change communication among residents Mucwini compared to their counterparts in Kitgum Midi. The authors recommend a more proactive approach in managing the epidemic by securing the willingness of the affected community to adopt appropriate infection prevention and control guidelines. In addition, disagreements among stakeholders should be resolved timely so that all community members adhere to control measures.

scholarly journals “We shall have gone to a higher standard”: Training village heath teams (VHTs) to use a smartphone-guided intervention to link older Ugandans with hypertension and diabetes to care

2020 ◽  
Vol 3 ◽  
pp. 25
Author(s):  
Joseph Okello Mugisha ◽  
Janet Seeley
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Older Adults ◽  
Blood Sugar ◽  
Standard Training ◽  
And Control ◽  
Depth Interviews ◽  
Study Setting ◽  
Village Health ◽  
Village Health Teams

Background: It is not clear whether village health teams (VHTs) can be empowered to participate in interventions to prevent and control hypertension and diabetes in older adults in Uganda. We conducted this study in rural Uganda to establish the experiences of VHTs in managing older adults with health problems, their knowledge of hypertension and diabetes and their understanding of referral systems. We also explored their experiences with smartphones and whether VHTs could be effectively trained to use a smartphone-guided intervention to link older adults with hypertension and diabetes mellitus to care. Methods: We conducted in-depth interviews (IDIs) with and trained 20 VHTs randomly selected from Bukulula sub-county in Kalungu district from October 2017-December 2018. We used interview guides to explore topics relevant to our study objectives. VHTs were trained to measure blood sugar and blood pressure using digital machines. VHTs were trained on identifying symptoms of diabetes mellitus. Data from IDIs were analysed using thematic content analysis. Competence tests were used to evaluate the training. Results: Most of the VHTs were female (75%). All VHTs had some knowledge on hypertension and diabetes and other chronic diseases. They did not have any experience in treating older adults since they had been trained to deal mainly with children. Half of the VHTs owned smartphones. All were willing to participate in an intervention using a smartphone to link older adults with hypertension and diabetes mellitus to care. By the end of the training, all but three participants could comprehend the symptoms of diabetes and measure blood sugar and blood pressure. Conclusion: Village health teams in the study setting need training in managing the health needs of older adults before engaging with an intervention using smartphones to link older adults with diabetes mellitus and hypertension to care.

scholarly journals Can the Timed and Targeted Counseling Model Improve the Quality of Maternal and Newborn Health Care? A Process Analysis in the Rural Hoima District in Uganda

2021 ◽  
Vol 18 (9) ◽  
pp. 4410
Author(s):  
Geoffrey Babughirana ◽  
Sanne Gerards ◽  
Alex Mokori ◽  
Isaac Charles Baigereza ◽  
Alex Mukembo ◽  
...  
Keyword(s):  
Health Care ◽  
Newborn Care ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Pregnancy And Childbirth ◽  
Care Practices ◽  
Village Health ◽  
Maternal And Newborn ◽  
Village Health Teams

Each year, more than half a million women die worldwide from causes related to pregnancy and childbirth, and nearly 4 million newborns die within 28 days of birth. In Uganda, 15 women die every single day from pregnancy and childbirth-related causes, 94 babies are stillborn, and 81 newborn babies die. Cost-effective solutions for the continuum of care can be achieved through Village Health Teams to improve home care practices and health care-seeking behavior. This study aims at examining the implementation of the timed and targeted counseling (ttC) model, as well as improving maternal and newborn health care practices. We conducted a quantitative longitudinal study on pregnant mothers who were recruited on suspicion of the pregnancy and followed-up until six weeks post-delivery. The household register was the primary data source, which was collected through a secondary review of the ttC registers. All outcome and process variables were analyzed using descriptive statistics. The study enrolled 616 households from 64 villages across seven sub-counties in Hoima district with a 98.5% successful follow-up rate. Over the course of the implementation period of ttC, there was an increase of 29.6% in timely 1st antenatal care, 28.7% in essential newborn care, 25.5% in exclusive breastfeeding, and 17.5% in quality of antenatal care. All these improvements were statistically significant. The findings from this study show that the application of the ttC model through Village Health Teams has great potential to improve the quality of antenatal and newborn care and the health-seeking practices of pregnant and breastfeeding mothers in rural communities.

scholarly journals Health Care Providers’ Challenges to High-Quality HIV Care and Antiretroviral Treatment Retention in Rural South Africa

2021 ◽  
Vol 31 (4) ◽  
pp. 722-735
Author(s):  
Aimée Julien ◽  
Sibyl Anthierens ◽  
Annelies Van Rie ◽  
Rebecca West ◽  
Meriam Maritze ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Antiretroviral Treatment ◽  
Hiv Care ◽  
Care Providers ◽  
Framework Analysis ◽  
High Quality ◽  
Rural South ◽  
Rural South Africa

Provision of high-quality HIV care is challenging, especially in rural primary care clinics in high HIV burden settings. We aimed to better understand the main challenges to quality HIV care provision and retention in antiretroviral treatment (ART) programs in rural South Africa from the health care providers’ perspective. We conducted semi-structured qualitative interviews with 23 providers from nine rural clinics. Using thematic and framework analysis, we found that providers and patients face a set of complex and intertwined barriers at the structural, programmatic, and individual levels. More specifically, analyses revealed that their challenges are primarily structural (i.e., health system- and microeconomic context-specific) and programmatic (i.e., clinic- and provider-specific) in nature. We highlight the linkages that providers draw between the challenges they face, the motivation to do their job, the quality of the care they provide, and patients’ dissatisfaction with the care they receive, all potentially resulting in poor retention in care.

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