Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Man, Jeroen De; Mayega, Roy William; Sarkar, Nandini; Waweru, Evelyn; Leys, Mart; Olmen, Josefien Van; Criel, Bart

doi:10.5750/ijpcm.v6i3.591

Cited by 58 publications

(57 citation statements)

References 80 publications

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“…This highlights the importance of PPC skills as the core in clinical practice and a key component of patient-centered care that promotes patient satisfaction with care. 4 , 20 , 21 Following the benefits reported among HIV patients satisfied with care including ART adherence 10 – 12 there is need for HIV care programs in this region to promote better interaction between providers and their patients through enhanced PPC skills.…”

Section: Discussionmentioning

confidence: 99%

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Higher Clinician-Patient Communication Is Associated With Greater Satisfaction With HIV Care

Wachira

Mwangi

Chemutai

et al. 2021

J Int Assoc Provid AIDS Care

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Provider-patient communication (PPC) skills are key in promoting patient satisfaction. Our study examined the relationship between clinician PPC skills and patient satisfaction with care among virally unsuppressed adult HIV patients in Busia County, Kenya. This cross-sectional study was conducted among 360 HIV patients on first line antiretroviral regimen and having a recent viral load ≥400 copies HIV RNA/ml. We conducted logistic regression analysis. The mean age of participants was 48.2 years [standard deviation (SD): 12.05]. Overall, the mean score on clinician PPC skills was 33.3 (SD: 9.0). A high proportion (85%) of participants reported satisfaction with the HIV care services. After adjusting for covariates, the odds of being satisfied with care increased by 19% (adjusted odds ratio: 1.19, 95% CI: 1.11-1.30) for every one unit increase in the clinician PPC skills score. Promoting good PPC skills may be key to improving patient satisfaction with HIV care.

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Section: Discussionmentioning

confidence: 99%

“… 1 – 3 Low capital and human resources, high demand for HIV services and a paternalistic approach to care have contributed to system level barriers in the region. 4 , 5 In light of these challenges, there is need to improve the quality of HIV care services in order to enhance patient adherence and retention in care.…”

Section: Introductionmentioning

confidence: 99%

Higher Clinician-Patient Communication Is Associated With Greater Satisfaction With HIV Care

Wachira

Mwangi

Chemutai

et al. 2021

J Int Assoc Provid AIDS Care

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“…However, some elements such as 'people first', accountability to the patient, holism, communication, HCP attitudes of friendliness, respect and empathy and family involvement do emerge in describing PCC. 9,10,11 This makes PCC conceptualisation blurry and hampers its successful implementation.…”

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confidence: 99%

The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi

Makwero

Muula

Anyawu

et al. 2021

Afr. j. prim. health care fam. med.

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Background: Patient-centred care (PCC) is one of the pillars of Malawi’s quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific.Aim: The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management.Setting: This study was conducted in DM clinics in Southern Malawi.Methods: Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower’s work.Results: Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants’ conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic.Conclusion: Patient-centred care conceptualisation in Malawi goes beyond the patient–HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

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“…63 , 68 Our findings agreed with the growing evidence from Sub-Saharan African countries where patient-centered care remains poorly implemented. 69 , 70 However, the role of patient-centered care is a well-recognized dimension of quality health care. 68 The ADA and European Association for the Study of Diabetes (EASD) consensus report highlights the PCC’s role in enhancing the patients’ engagement in diabetes self-care practices.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Diabetes Patients’ Self-Care Practices in Eastern Ethiopia: A Qualitative Study from the Health Care Providers Perspective

Letta¹,

Aga²,

Yadeta³

et al. 2021

DMSO

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Background All types of diabetes can damage the heart, blood vessels, eyes, kidneys, nerves and increase the overall risk of disability and premature death. Diabetes mellitus requires a range of self-care practices, scientifically recommended to control the glycemic level and maintain the patient’s health. However, perceived barriers that hinder patients from fully implementing these diabetes self-care practices and obstacles have not been thoroughly explored. Therefore, this study aimed to explore the barriers to diabetes patients’ self-care practices from the perspective of health care providers in two public hospitals in Harar City, Eastern Ethiopia. Methods Researchers conducted an exploratory qualitative study among 26 health care providers working in two public hospitals from March to June 2021. The study participants were recruited from different disciplines working on diabetes care. Interviews were conducted in the Amharic language until the saturation point was reached. The interviews were tape-recorded, transcribed, and translated to English. Each transcript was read, re-read, and then exported to ATLAS.ti 7 software for coding. Field notes were used to supplement verbatim transcriptions. Initial codes were generated. The consistency between the two coders and their alignment with research questions were checked and applied to all subsequent transcripts after reached on consensus. The thematic analysis was employed in line with the primary set research question. Results Researchers identified barriers to diabetes patients’ self-care practices such as system, health care providers, and patient-level. These barriers were categorized under three main themes: lack of organized diabetes care services, limited collaborative care practices, and perceived lack of knowledge on self-care practices. In addition, the lack of multidisciplinary team care, lack of training for health care providers on diabetes self-care practices, and availability of laboratory tests and diabetes medication were prominent barriers. Conclusion Multi-level barriers to diabetes patients’ self-care practices such as system, health care providers, and patients were identified. Therefore, interventions targeting proper service integration, building providers’ and patients’ capacity on diabetes self-care practices, and ensuring the sustainability of laboratory tests and medication supplies are essential. These interventions need to be accomplished through multi-level stakeholders’ engagement and one-to-one or group interventions covering the multi-level challenges.

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Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Cited by 58 publications

References 80 publications

Higher Clinician-Patient Communication Is Associated With Greater Satisfaction With HIV Care

Higher Clinician-Patient Communication Is Associated With Greater Satisfaction With HIV Care

The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi

Barriers to Diabetes Patients’ Self-Care Practices in Eastern Ethiopia: A Qualitative Study from the Health Care Providers Perspective

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