Satisfaction with use of public health and peer-led facilities for HIV prevention services by key populations in Nigeria

Abstract Background The aim of the study was to identify the proportion of female sex workers, men who have sex with men, and people who inject drugs who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services, and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers. Methods A mixed-method approach was used to collect data from key populations in the four states in Nigeria. Quantitative data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews and focus-group discussions were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analyses were was conducted for quantitative data. Qualitative data were summaried, emerging themes identified, described and quotes reflecting the themes corresponding to interview questions highlighted. Results Nine hundred sixty-seven persons responded to questions on the use of public health or/and peer-led facilities. Two hundred thirty-eight (49.4%) respondents had received HIV and sexual and reproductive health services through public health facilities, and 236 (48.7%) had received the services through peer-led facilities. Significantly more respondents were satisfied with the quality of services provided by peer-led organisations than with public health facilities with respect to service providers listening to respondent’s problems and concerns (p = 0.007),privacy and confidentiality (p = 0.04) and respect of rights of service recipients (p = 0.04). Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p = 0.003). More respondents using public health facilities than peer-led facilities identified cost of services (p = 0.01), confidentiality (p = 0.002), waiting time (p < 0.01) and staff attitude (p = 0.001) as barriers to service access. Thee was no difference in the proportion of respondents willing to discontinue their use of either facilities (p = 0.08). Qualitative data revealed that concerns with access of services at the public health facility were due mainly to stigma and the effects of the same-sex prohibition law. Conclusion Key populations were more satisfied receiving HIV prevention services at peer-led organisations than at public health facilities.

Download Full-text

SATISFACTION WITH USE OF PUBLIC HEALTH AND PEER LED FACILITIES FOR HIV PREVENTION SERVICES BY KEY POPULATIONS IN NIGERIA

10.21203/rs.2.11193/v4 ◽

2019 ◽

Author(s):

Bartholomew Ochonye ◽

Morenike Oluwatoyin Folayan ◽

Adesegun O Fatusi ◽

Godwin Emmanuel ◽

Tomi Adepoju ◽

...

Keyword(s):

Public Health ◽

Hiv Prevention ◽

Service Providers ◽

Health Facilities ◽

Service Access ◽

Key Populations ◽

Public Health Facilities ◽

Prevention Services ◽

Barriers To Service ◽

Barriers To Use

Abstract Background: The aim of the study was to identify the proportion of female sex workers, men who have sex with men, and people who inject drugs who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services, and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers. Methods: A mixed-method approach was used to collect data from key populations in the four states in Nigeria. Quantitative data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews and focus-group discussions were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analyses were was conducted for quantitative data. Qualitative data were summaried, emerging themes identified, described and quotes reflecting the themes corresponding to interview questions highlighted Results : Nine hundred sixty-seven persons responded to questions on the use of public health or/and peer-led facilities. Two hundred thirty-eight (49.4%) respondents had received HIV and sexual and reproductive health services through public health facilities, and 236 (48.7%) had received the services through peer-led facilities. Significantly more respondents were satisfied with the quality of services provided by peer-led organisations than with public health facilities with respect to service providers listening to respondent’s problems and concerns (p=0.007),privacy and confidentiality (p=0.04) and respect of rights of service recipients (p=0.04). Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer-led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. Thee was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08). Qualitative data revealed that concerns with access of services at the public health facility were due mainly to stigma and the effects of the same-sex prohibition law. Conclusion: Key populations were more satisfied receiving HIV prevention services at peer-led organisations than at public health facilities.

Download Full-text

Satisfaction With Use Of Public Health And Peer-Led Facilities For Hiv Prevention Services By Key Populations In Nigeria

10.21203/rs.2.11193/v3 ◽

2019 ◽

Author(s):

Bartholomew Ochonye ◽

Morenike Oluwatoyin Folayan ◽

Adesegun O Fatusi ◽

Godwin Emmanuel ◽

Tomi Adepoju ◽

...

Keyword(s):

Public Health ◽

Hiv Prevention ◽

Service Providers ◽

Health Facilities ◽

Service Access ◽

Key Populations ◽

Public Health Facilities ◽

Prevention Services ◽

Barriers To Service ◽

Barriers To Use

Abstract Background: The aim of the study was to identify the proportion of female sex workers, men who have sex with men, and people who inject drugs who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services, and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers. Methods: A mixed-method approach was used to collect data from key populations in the four states in Nigeria. Quantitative data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews and focus-group discussions were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analyses were was conducted for quantitative data. Qualitative data were summaried, emerging themes identified, described and quotes reflecting the themes corresponding to interview questions highlighted Results: Nine hundred sixty-seven persons responded to questions on the use of public health or/and peer-led facilities. Two hundred thirty-eight (49.4%) respondents had received HIV and sexual and reproductive health services through public health facilities, and 236 (48.7%) had received the services through peer-led facilities. Significantly more respondents were satisfied with the quality of services provided by peer-led organisations than with public health facilities with respect to service providers listening to respondent’s problems and concerns (p=0.007),privacy and confidentiality (p=0.04) and respect of rights of service recipients (p=0.04). Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer-led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. Thee was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08). Qualitative data revealed that concerns with access of services at the public health facility were due mainly to stigma and the effects of the same-sex prohibition law. Conclusion: Key populations were more satisfied receiving HIV prevention services at peer-led organisations than at public health facilities.

Download Full-text

Satisfaction With Use Of Public Health And Peer-Led Facilities For Hiv Prevention Services By Key Populations In Nigeria

10.21203/rs.2.11193/v2 ◽

2019 ◽

Author(s):

Bartholomew Ochonye ◽

Morenike Oluwatoyin Folayan ◽

Adesegun O Fatusi ◽

Godwin Emmanuel ◽

Tomi Adepoju ◽

...

Keyword(s):

Public Health ◽

Hiv Prevention ◽

Health Facilities ◽

Service Access ◽

Key Populations ◽

Public Health Facilities ◽

Prevention Services ◽

Level Of Satisfaction ◽

Barriers To Service ◽

Barriers To Use

Abstract Objective: To identify the proportion of FSW, MSM and PWID who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers. Methods: A mixed method approach was used to collect data from key populations in four states in Nigeria. Data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews and focus group discussions were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analysis was conducted for quantitative data. A ground theory approach was used to analyse the qualitative data. Results : There were 482 and 485 respondents to the questions on use of public health and peer-led facilities. Of these, 49.4% and 48.7% had received HIV and sexual and reproductive health services through the public health and peer-led facilities respectively. Significantly more respondents were satisfied with the quality of services provided by peer led organisations than public health facilities. Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. There was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08). Qualitative data showed that concerns about access of services at the public health facility were related to healthcare worker discrimination and fear of being arrested due to the enacted same-sex prohibition law in Nigeria. Conclusion: Key populations had better satisfaction receiving HIV prevention services at peer led organisations than at public health facilities.

Download Full-text

Satisfaction With Use Of Public Health And Peer Led Facilities For HIV Prevention Services By Key Populations In Nigeria

10.21203/rs.2.11193/v1 ◽

2019 ◽

Author(s):

Bartholomew Ochonye ◽

Morenike Oluwatoyin Folayan ◽

Adesegun O Fatusi ◽

Godwin Emmanuel ◽

Tomi Adepoju ◽

...

Keyword(s):

Public Health ◽

Hiv Prevention ◽

Health Facilities ◽

Service Access ◽

Key Populations ◽

Public Health Facilities ◽

Prevention Services ◽

Level Of Satisfaction ◽

Barriers To Service ◽

Barriers To Use

Abstract Background To identify the proportion of FSW, MSM and PWID who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers. Settings Four states in Nigeria Methods A mixed method approach was used to collect data from key populations in four states in Nigeria. Data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analysis was conducted for quantitative data. Results 49.4% of the 482 respondents, and 48.7% of the 485 respondents to the question, had received HIV and sexual and reproductive health services through the public health and peer-led facilities respectively. Significantly more respondents were satisfied with the quality of services provided by peer led organisations than public health facilities. Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. There was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08). Conclusion Key populations had better satisfaction receiving HIV prevention services at peer led organisations than at public health facilities.

Download Full-text

Feasibility of delivering integrated COPD-asthma care at primary and secondary level public healthcare facilities in Pakistan: a process evaluation

BJGP Open ◽

10.3399/bjgpopen18x101632 ◽

2019 ◽

Vol 3 (1) ◽

pp. bjgpopen18X101632 ◽

Cited By ~ 2

Author(s):

Muhammad Amir Khan ◽

Muhammad Ahmar Khan ◽

John D Walley ◽

Nida Khan ◽

Faisal Imtiaz Sheikh ◽

...

Keyword(s):

Public Health ◽

Integrated Care ◽

Low Income ◽

Service Providers ◽

Health Facilities ◽

Public Healthcare ◽

Care Providers ◽

Asthma Care ◽

Public Health Facilities ◽

Clinical Records

BackgroundIn Pakistan,the estimated prevalence of chronic obstructive pulmonary disease (COPD) and asthma are 2.1% and 4.3% respectively, and existing care is grossly lacking both in coverage and quality. An integrated approach is recommended for delivering COPD and asthma care at public health facilities.AimTo understand how an integrated care package was experienced by care providers and patients, and to inform modifications prior to scaling up.Design & settingThe mixed-methods study was conducted as part of cluster randomised trials on integrated COPD and asthma care at 30 public health facilities.MethodThe care practices were assessed by analysing the clinical records of n = 451 asthma and n = 313 COPD patients. Semi-structured interviews with service providers and patients were used to understand their care experiences. A framework approach was applied to analyse and interpret qualitative data.ResultsUtilisation of public health facilities for chronic lung conditions was low, mainly because of the non-availability of inhalers. When diagnosed, around two-thirds (69%) of male and more than half (55%) of female patients had severe airway obstruction. The practice of prescribing inhalers differed between intervention and control arms. Patient non-adherence to follow-up visits remained a major treatment challenge (though attrition was lower and slower in the intervention arm). Around half of the male responders who smoked at baseline reported having quit smoking.ConclusionThe integrated care of chronic lung conditions at public health facilities is feasible and leads to improved diagnosis and treatment in a low-income country setting. The authors recommend scaling of the intervention with continued implementation research, especially on improving patient adherence to treatment.

Download Full-text

Assessment of cervical cancer services and cervical cancer related knowledge of health service providers in public health facilities in Addis Ababa, Ethiopia

BMC Research Notes ◽

10.1186/s13104-019-4701-6 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 2

Author(s):

Firdawek Getahun ◽

Adamu Addissie ◽

Shiferaw Negash ◽

Gebrekiros Gebremichael

Keyword(s):

Public Health ◽

Cervical Cancer ◽

Health Service ◽

Service Providers ◽

Addis Ababa ◽

Health Facilities ◽

Health Providers ◽

Public Health Facilities ◽

Health Service Providers ◽

Cancer Services

Abstract Objective To assess cervical cancer services and knowledge of health service providers in public health facilities. Result Two of the three hospitals had cervical cancer screening services. One-third of the hospital had cervical cancer diagnosis service punch biopsy and cervical cancer treatment. Majority, 289 (93.5%) of study participants said cervical cancer was a preventable disease. Having multiple sexual partners 257 (83.2%) and post coital bleeding 251 (81.2%), were the most mentioned risk factor and clinical manifestation of cervical cancer respectively. Majority of the participants were aware of the correct time to start screening 291 (70.5%), and only 95 (25.9%) knew the screening intervals. Overall, 165 (53.4%) of health providers scored below the mean knowledge level score. Females had better knowledge about cervical cancer than males (X2 = 8.4, P = 0.003).

Download Full-text

Universal Access to Essential Medicines: An Evaluation of Nepal’s Free Health Care Scheme

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v16i1.19361 ◽

2018 ◽

Vol 16 (1) ◽

pp. 36-42 ◽

Cited By ~ 2

Author(s):

Shiva Raj Adhikari ◽

Achyut Raj Pandey ◽

Mamata Ghimire ◽

Arjun Kumar Thapa ◽

Dinesh Kumar Lamsal

Keyword(s):

Public Health ◽

Health Care ◽

Service Providers ◽

Universal Access ◽

Health Facilities ◽

Essential Medicines ◽

Public Health Facilities ◽

Free Health Care ◽

Access To Essential Medicines ◽

Expired Medicines

Background: Access to medicine for the poor is recognized to be difficult task and one of the major challenges in achieving universal health coverage, particularly in low-and- middle income countries. In order to ensure the availability of essential medicines free of cost in public health facilities, Nepal has also commenced Free Health Care Services (FHCS). So, this study aims to evaluate availability, expiry, and stock-out duration of essential medicines at front line service providers in Nepal.Methods: Cross-sectional survey was conducted 28 public health facilities, 7 district warehouses, and 14 private pharmacies in 7 districts of Nepal. The survey was conducted during the March and April 2014. Survey tools recommended by the WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations was used with slight modification as per Nepal’s situation.Results: The availability of medicine was found to be 92.44% in this study. The percentage of expired medicines in district warehouse was found to be 8.40. The average stock-out duration in district warehouse was 0.324 days.Conclusions: Although the availability of essential medicines at peripheral health facilities was found to be satisfactory with lesser proportion of expired medicines, a strong monitoring and evaluation of expired and stock medicines are desirable to maintain and improve the access to essential medicines.

Download Full-text

Optimizing HIV Services for Key Populations in Public-Sector Clinics in Myanmar

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/23259582211055933 ◽

2021 ◽

Vol 20 ◽

pp. 232595822110559

Author(s):

Ansley Lemons-Lyn ◽

William Reidy ◽

Wah Wah Myint ◽

Khin N. Chan ◽

Elaine Abrams ◽

...

Keyword(s):

Public Health ◽

Healthcare Worker ◽

Healthcare Workers ◽

Structural Changes ◽

Health Facilities ◽

Key Populations ◽

Structural Barriers ◽

Hiv Services ◽

Public Health Facilities ◽

Key Population

Key populations, ie, female sex workers, men who have sex with men, transgender people, people who inject drugs, and people in prisons and other closed settings, experience stigma, discrimination, and structural barriers when accessing HIV prevention and care. Public health facilities in Myanmar became increasingly involved in HIV service delivery, leading to an urgent need for healthcare workers to provide client-centred, key population-friendly services. Between July 2017–June 2018, the Myanmar Ministry of Health and Sports and National AIDS Programme collaborated with ICAP at Columbia University and the US Centers for Disease Control and Prevention to implement a quasi-experimental, multicomponent intervention including healthcare worker sensitization training with pre- and post- knowledge assessments, healthcare worker and client satisfaction surveys, and structural changes. We observed modest improvements among healthcare workers (n = 50) in knowledge assessments. Classification of clients into key population groups increased and fewer clients were classified as low risk. Key population clients reported favourable perceptions of the quality and confidentiality of care through self-administered surveys. Our findings suggest public health facilities can deliver HIV services that are valued by key population clients.

Download Full-text

Effectiveness of a quality improvement intervention to increase adherence to key practices during female sterilization services in Chhattisgarh and Odisha states of India

PLoS ONE ◽

10.1371/journal.pone.0244088 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244088

Author(s):

Ashish Srivastava ◽

Geeta Chhibber ◽

Neeta Bhatnagar ◽

Angela Nash-Mercado ◽

Jyoti Samal ◽

...

Keyword(s):

Public Health ◽

Quality Improvement ◽

Service Providers ◽

Health Facilities ◽

Quality Improvement Intervention ◽

Female Sterilization ◽

Public Health Facilities ◽

Operative Care ◽

Urine Testing ◽

The Impact

Background In response to longstanding concerns around the quality of female sterilization services provided at public health facilities in India, the Government of India issued standards and quality assurance guidelines for female sterilization services in 2014. However, implementation remains a challenge. The Maternal and Child Survival Program rolled out a package of competency-based trainings, periodic mentoring, and easy-to-use job aids in parts of five states to increase service providers’ adherence to key practices identified in the guidelines. Methods The study employed a before-and-after quasi-experimental design with a matched comparison arm to examine the effect of the intervention on provider practices in two states: Odisha and Chhattisgarh. Direct observations of female sterilization services were conducted in selected public health facilities, using a checklist of 30 key practices, at two points in time. Changes in adherence to key practices from baseline to endline were compared at 12 intervention and 12 comparison facilities using a difference in difference analysis. Results Several key practices were well-established prior to the intervention, with adherence levels over 90% at baseline, including hemoglobin and urine testing, use of sterile surgical gloves and instruments, and recommended surgical technique. However, adherence to many other practices was extremely low at baseline. The program significantly increased adherence to nine practices, including those related to ascertaining client’s medical eligibility, client-provider interaction, the consent process, and post-operative care. The greatest improvement was observed in the provision of written instructions for clients prior to discharge. At endline, however, adherence remained below 50% for 14 practices. Conclusion Low adherence to key practices at baseline confirmed the need for quality improvement interventions in female sterilization services. While the intervention improved adherence to certain practices around admission and post-operative care, inadequate human resources and infrastructure, among other factors, may have blunted the impact of the intervention.

Download Full-text