Systematic review: Development of a person‐centered care framework within the context of HIV treatment settings in sub‐Saharan Africa

Abstract

Objectives: Person-centred care (PCC) meets the needs of individuals by increasing convenience, providing supportive and culturally appropriate services to diverse populations, and engaging families, communities, and stakeholders in planning and provision of care. While the evidence demonstrates that PCC approaches can lead to clinical improvements across the HIV care continuum, it is not yet well defined in the context of HIV service delivery. Methods: A systematic review was conducted to define PCC practices for HIV treatment services in health facilities in sub-Saharan Africa. Data synthesis led to the development of a PCC framework including domain and sub-domain development. The study team used the Effective Public Health Project Practice tool for quantitative studies to assess the quality of the included studies. Results: Thirty-one studies from 12 countries met the inclusion criteria, including 56,586 study participants (females 42%-100% and males 0%-58%), resulting in three major domains and 11 sub-domains. These include staffing (sub-domains of composition, availability, and competency); service delivery standards (sub-domains of client feedback mechanisms; service efficiency and integration; convenience and access; and digital health worker support tools); and direct client support services (sub-domains of psychosocial services, logistics support, client-agency, and digital client support tools). Twenty-five of the person-centred interventions within these domains resulted in improvements in linkage to care, treatment retention, and/or viral suppression. Conclusions: The PCC framework can help to provide a more consistent classification of HIV treatment interventions and will support improved assessment of these interventions to ensure that people receive personalised care. K E Y W O R D S client-centred care, HIV, HIV care continuum, HIV treatment, person-centred care, sub-

Assessing the person-centered care framework and assessment tool (PCC-AT) in HIV treatment settings in Ghana: A pilot study protocol

“…This study builds upon a previous systematic literature review published elsewhere by this team that established a framework for PCC for HIV treatment service delivery. [15] The initial framework identified three key domains (Staffing, Service provision, Direct client support) and 11 subdomains (respectively: composition, availability, competency; client feedback mechanisms, service efficiency and integration, convenience and access, digital health worker support tools; psychosocial support, logistical support, client agency, digital client support tools).…”

Perceptions and Current Practices in Patient-Centered Care: A Qualitative Study of Ryan White HIV Providers in South Florida

“…Despite clear benefits, a lack of consensus on the conceptualization, ideal framework, measures and implementation strategies for PCC in HIV care settings persists, 6 , 20 impeding the implementation of high-quality PCC practices. For example, in HIV care settings, there is a greater focus on structural components of PCC application, and less emphasis on interpersonal (patient-provider) factors despite their critical role in promoting good care.…”

Facilitating person‐centred care: integrating an electronic client feedback tool into continuous quality improvement processes to deliver client‐responsive HIV services in the Democratic Republic of Congo

“…. and hold potential for people to shape services based upon their own needs [6,7]." Numerous studies have also highlighted the efficacy of using continuous quality improvement (CQI) to improve healthcare quality [8], including to promote person-centred HIV services [9][10][11].…”