Are we too far from being client centered?

Erchafo, Belay; Alaro, Tesfamichael; Tsega, Gebeyehu; Adamu, Ayinengida; Yitbarek, Kiddus; Siraneh, Yibeltal; Hailu, Meaza; Woldie, Mirkuzie

doi:10.1371/journal.pone.0205681

Cited by 6 publications

(6 citation statements)

References 27 publications

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“…The mean score was then multiplied by 4 in order to make domain scores comparable with the scores used in the WHOQOL instrument (WHOQOL-100). 21 The overall percentage mean score for quality of life of PLWH in this study was calculated using the following formula: 22 Percentages mean score ¼ Actual score À potential minimum score Potential maximum score À potential minimum score…”

Section: Data Processing and Analysismentioning

confidence: 99%

“…Then, the mean score of percent mean scores was used as a cut-off to categorize the participants as poor (less than the mean score) and good (greater than or equal to the mean score). 21,22…”

Section: Operational Definitionsmentioning

confidence: 99%

“…In addition, individuals scoring above and equal to the mean social support score were categorized as "good social support" and those scoring below the mean were classified as "poor social support". 22…”

Section: Social Supportmentioning

confidence: 99%

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<p>Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia</p>

Tesemma¹,

Abate²,

Abebo³

et al. 2019

HIV

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Background: The human immunodeficiency virus (HIV) continues to be a major global public health problem with more than 35 million people worldwide infected so far. Evidence shows that HIV has been compromising the quality of life of people living with HIV (PLWH) even in this era of highly active anti-retroviral therapy (HAART). There has been little research into the quality of life of PLWH receiving HAART in Ethiopia. Purpose: The aim of this study was to assess the quality of life among PLWH attending anti-retroviral therapy at public health facilities of Arba Minch town, Southern Ethiopia, in 2019. Patients and methods: We conducted a cross-sectional study design on 391 randomly selected PLWH who were attending HAART. We used a systematic random sampling technique to select participants in public health facilities of Arba Minch town from February 16 to April 26, 2019. The interviewers administered a structured questionnaire consisting of the WHOQOL-HIV BREF tool to measure the quality of life. Socio-demographic variables of study participants were collected, together with variables related to their clinical status extracted from their clinical records. Percentage mean scores were calculated and the mean of percentage mean scores was taken as the cutoff to categorize participants into two groups representing poor and good quality of life. Simple binary logistic regression and multivariable logistic regression analyses were used to determine significant variables. All variables with p-value ≤ 0.25 in simple binary logistic regression were considered as eligible variables for multivariable logistic regression. Variables with p-value ≤ 0.05 in multivariable logistic regression were considered as predictor variables. Results: Out of the 391 enrolled adult PLWH, 184 of them (47.1%) had poor of overall quality of life status, as estimated by the WHOQOL-HIV BREF tool. Good quality of life was positively associated with recent CD4 count greater than or equal to 500 cell/mm 3 (AOR=1.96, 95% CI; 1.18-3.27), absence of depression (AOR=10.59, 95% CI; 6.16-18.21), normal body mass index (AOR=2.66, 95% CI; 1.18-3.27), social support (AOR= 6.18, 95% CI; 3.56-10.75) and no perceived stigma (AOR=2.75, 95% CI; 1.62-4.67). Conclusion: Nearly half of the adult PLWH receiving HAARTat Arba Minch town had poor quality of life. High CD4 count, lack of social support, depression, and perceived stigma were associated with poor quality of life of PLWH. PLWH should be encouraged to be part of structured social support systems, such as associations of people living with HIVand mother support groups, in order to improve their social and psychological health. The health system should give attention to counseling on chronic care adherence and nutritional support to improve the quality of life of PLWH receiving HAART.

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Section: Data Processing and Analysismentioning

confidence: 99%

Section: Operational Definitionsmentioning

confidence: 99%

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<p>Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia</p>

Tesemma¹,

Abate²,

Abebo³

et al. 2019

HIV

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“…Yet, in this study, providers minimally gave feedback to women on the assessments done and care actions taken. As reported by Erchafo and others ( 40 ), less involvement of women in their and their babies’ care can make them feel less valued, disrespected, and mistreated. Another implication of women not being aware of procedures or actions taken for their care is that it can affect their health beyond labor and childbirth ( 41 ).…”

Section: Discussionmentioning

confidence: 86%

Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia

Siseho

Mathole²,

Jackson³

2023

Front. Pediatr.

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BackgroundQuality of care around childbirth can reduce above half of the stillbirths and newborn deaths. Northeast Namibia’s neonatal mortality is higher than the national level. Yet, no review exists on the quality of care provided around childbirth. This paper reports on baseline assessment for implementing WHO/UNICEF/UNFPA quality measures around childbirth.MethodsA mixed-methods research design was used to assess quality of care around childbirth. To obtain good saturation and adequate women opinions, we purposively sampled the only high-volume hospital in northeast Namibia; observed 53 women at admission, of which 19 progressed to deliver on the same day/hours of data collection; and interviewed 20 staff and 100 women who were discharged after delivery. The sampled hospital accounted for half of all deliveries in that region and had a high (27/1,000) neonatal mortality rate above the national (20/1,000) level. We systematically sampled every 22nd delivery until the 259 mother–baby pair was reached. Data were collected using the Every Mother Every Newborn assessment tool, entered, and analyzed using SPSS V.27. Descriptive statistics was used, and results were summarized into tables and graphs.ResultsWe reviewed 259 mother–baby pair records. Blood pressure, pulse, and temperature measurements were done in 98% of observed women and 90% of interviewed women at discharge. Above 80% of human and essential physical resources were adequately available. Gaps were identified within the WHO/UNICEF/UNFPA quality standard 1, a quality statement on routine postpartum and postnatal newborn care (1.1c), and also within standards 4, 5, and 6 on provider–client interactions (4.1), information sharing (5.3), and companionship (6.1). Only 45% of staff received in-service training/refresher on postnatal care and breastfeeding. Most mothers were not informed about breastfeeding (52%), postpartum care and hygiene (59%), and family planning (72%). On average, 49% of newborn postnatal care interventions (1.1c) were practiced. Few mothers (0–12%) could mention any newborn danger signs.ConclusionThis is the first study in Namibia to assess WHO/UNICEF/UNFPA quality-of-care measures around childbirth. Measurement of provider–client interactions and information sharing revealed significant deficiencies in this aspect of care that negatively affected the client’s experience of care. To achieve reductions in neonatal death, improved training in communication skills to educate clients is likely to have a major positive and relatively low-cost impact.

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“…However, 2015 estimates show that mortality remains high in the months before and after childbirth, with 420 mothers dying per 100,000 live births, 41 infants dying per 1000 live births, 28 neonates dying per 1000 live births and neonatal deaths accounting for 47% of all under-five mortality [7,8] In line with Sustainable Development Goals, by 2020 Ethiopia aims to reduce the maternal mortality ratio to 199 per 100,000 live births, the infant mortality rate to 20 per 1000 live births and the neonatal mortality rate to 10 per 1000 live births, [9]. This requires more than three times the 2.3% annual rate of reduction observed globally between 1990 and 2015 [7,10]. In developing countries, however, interest in improving process quality of health care has been surprisingly low until recently.…”

Section: Introductionmentioning

confidence: 99%

Process Quality of Antenatal Care Among Clients of Antenatal Care Service Users and Service Providers in Public Hospitals of Woliata Zone, Southern Ethiopia

Mekonnen¹

2021

JGWH

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Background: Many women are dying due to factors related to pregnancy and childbirth, especially in developing countries including Ethiopia, where maternal mortality ratio is one of the highest in the world. In Ethiopia, most women have had antenatal care visit, however the goal, reduction in maternal mortality, is yet not in line with the 2030 Sustainable Development Goal particularly in rural areas, where the process quality has gap.Methods and Objectives: Facility-based cross-sectional study was to determine sum score of process quality of Antenatal care services among mothers who attended antenatal care service during the study period in Woliata Zone, Southern Ethiopia. Data collection took place using smart phones running Google's Android operating system from 704 participants via observation. The phones were equipped with Open Data Kit (ODK) software. Logistic regression was performed using SPSS version 24.0 Result: A total of 704 pregnant women were included in the analysis. Only 52.3% of antenatal care attendants met Process quality of the service in antenatal clinic while discussing with the service provider. In binary logistic regression; advise the client to use skilled health worker for delivery AOR= 21.0 (95%CI:6.3, 69.6), discussed heavy vaginal bleeding during or after birth AOR=1.6 (95%CI:1.0‚ 2.5) , take client's blood pressure AOR,2.1(95%CI:1.1‚ 4.2), asked the client where she will deliver AOR =2.6(95%CI:1.7,4.2), advise the client to prepare for delivery AOR, 3.1(95%CI : 2.0‚4.9), provide counselling related to HIV AOR=1.8(95%CI:1.0,3.0) and examine conjunctiva or palms for anaemia AOR=1.8(95%CI:1.0,3.1) were statistically significant predictors of the process quality of antenatal care service in the study period in Woliata Zone, Southern Ethiopia. Conclusion:Sum score of Process quality of Care among antenatal care service users was low compared to national standard. Informing women that getting standard process quality service is their right, and encouragement of mothers regarding the need for Process quality of the services is of crucial. Providers must be in line with principles of screening and counselling.

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Are we too far from being client centered?

Cited by 6 publications

References 27 publications

<p>Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia</p>

<p>Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia</p>

Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia

Process Quality of Antenatal Care Among Clients of Antenatal Care Service Users and Service Providers in Public Hospitals of Woliata Zone, Southern Ethiopia

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