The willingness to receive sexually transmitted infection services from public healthcare facilities among key populations at risk for human immunodeficiency virus infection in Bangladesh: A qualitative study

et al. 2019

BMC Health Serv Res

BackgroundThe 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.MethodsA 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.ResultsNine 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.ConclusionKey populations were more satisfied receiving HIV prevention services at peer-led organisations than at public health facilities.

Section: Discussioncontrasting

confidence: 99%

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

Ochonye¹,

et al. 2019

BMC Health Serv Res

“…The level of satisfaction with services and the high proportion of service users who indicated willingness to continue using the services (either public sector health facilities or peer-led services) is striking. This finding contrasts with that reported for key populations in Bangladesh, where most service users indicated unwillingness to return to public health facilities because of perceived low quality of care [49]. On the one hand, our result may imply that the quality of HIV prevention services in the focal Nigerian states is good and acceptable, which is in contrast with most reports about the quality of health care in the country [50][51][52][53].…”

Section: Discussioncontrasting

confidence: 99%

Satisfaction With Use of Public Health and Peer Led Facilities for Hiv Prevention Services by Key Populations in Nigeria

Ochonye

et al. 2019

Preprint

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.

“…The level of satisfaction with services and the high proportion of service users who indicated willingness to continue to use the services (the public sector health facilities or the peer-led services, as the case may be) again is striking. Our finding contrast that reported for key populations in Bangladesh where most service users indicate unwillingness to return to public health facilities where they had sought care again because of perceived low quality [49]. On the one hand, this finding may imply that the quality of HIV prevention services in the focal states is good and acceptable which is in contrast to most reports about the quality of health care in Nigeria [50][51][52][53].…”

Section: Discussioncontrasting

confidence: 99%

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

Ochonye

et al. 2019

Preprint

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.