Service Delivery Factors That Influence Utilization of HIV Integrated Primary Health Care Programme in Embu Referral Hospital, Kenya

Abstract

Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach's alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ 2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ 2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ 2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ 2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting

Feasibility and acceptability of integrating hepatitis B care into routine HIV services: a qualitative study among health care providers and patients in West Nile region, Uganda

“…HIV Client FGDs were especially concerned about a potential decline in the quality of services they have been receiving, and feared implications like clinic delays due to patient overload, inadvertent infection-status exposure and even drug stock-outs. A study in Kenya [25] has comparably linked higher satisfaction with service quality to increased uptake of integrated services. These concerns also corroborate those from the recipient community on scale-up of HIV care differentiation in Uganda [26], suggesting that feasibility and sustainability of integrated care will depend on quality of the integrated services.…”