Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage

Asfaw, Elias; Dominis, Sarah; Palen, John; Wong, Wendy; Bekele, Abebe; Kebede, Amha; Johns, Benjamin

doi:10.1093/heapol/czu072

Cited by 17 publications

(19 citation statements)

References 22 publications

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“…This suggests that task-shifting has assisted in expanding access and maintaining HATCS without compromising quality and satisfaction with services. This has also been confirmed by other studies [ 60 , 61 ]. However, the quality of care was affected when HATCS were provided by untrained staff, increasing the chances of malpractice and changes in treatment plans.…”

Section: Discussionsupporting

confidence: 91%

A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research

Yakob¹,

Ncama²

2016

BMC Public Health

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BackgroundAccess to healthcare is an essential element of health development and a fundamental human right. While access to and acceptability of healthcare are complex concepts that interact with different socio-ecological factors (individual, community, institutional and policy), it is not known how these factors affect HIV care. This study investigated the impact of socio-ecological factors on access to and acceptability of HIV/AIDS treatment and care services (HATCS) in Wolaita Zone of Ethiopia.MethodQualitative case study research was conducted in six woredas (districts). Focus group discussions (FGDs) were conducted with 68 participants in 11 groups (six with people using antiretroviral therapy (ART) and five with general community members). Key informant interviews (KIIs) were conducted with 28 people involved in HIV care, support services and health administration at different levels. Individual in-depth interviews (IDIs) were conducted with eight traditional healers and seven defaulters from (ART). NVIVO 10 was used to assist qualitative content data analysis.ResultsA total of 111 people participated in the study, of which 51 (45.9 %) were male and 60 (54.1 %) were female, while 58 (53.3 %) and 53 (47.7 %) were urban and rural residents, respectively. The factors that affect access to and acceptability of HATCS were categorized in four socio-ecological units of analysis: client-based factors (awareness, experiences, expectations, income, employment, family, HIV disclosure and food availability); community-based factors (care and support, stigma and discrimination and traditional healing); health facility-based factors (interactions with care providers, availability of care, quality of care, distance, affordability, logistics availability, follow up and service administration); and policy and standards (healthcare financing, service standards, implementation manuals and policy documents).ConclusionsA socio-ecological perspective provides a useful framework to investigate the interplay among multilevel and interactive factors that impact on access to and acceptability of HATCS such as clients, community, institution and policy. Planners, resource allocators and implementers could consider these factors during planning, implementation and evaluation of HATCS. Further study is required to confirm the findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2830-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research

Yakob¹,

Ncama²

2016

BMC Public Health

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“…High scores in the interpersonal manner construct showed that the patients were satisfied with the professional manner and empathy of the healthcare providers. Satisfaction in these two constructs might explain the correspondingly good levels of general satisfaction reported by the PLHIV clients [16]. Technical quality was perceived by the routine ART service group to be significantly better than that reported by the patients in the task-shifted service group (Table 2).…”

Section: Discussionmentioning

confidence: 94%

“…Existing literature shows that patient satisfaction was an important indicator in evaluating healthcare service delivery or intervention [14]. Researchers in the United States, Vietnam, Ethiopia, and India reported the impact of task-shifted ART service, applying patient satisfaction as the study outcome [13,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Satisfaction of HIV patients with task-shifted primary care service versus routine hospital service in northern Thailand

Aung

Moolphate

Kitajima

et al. 2015

J Infect Dev Ctries

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Introduction: Shifting the task of HIV care to primary care providers is an important strategy to sustain expanding access to antiretroviral therapy (ART) in high HIV burden countries like Thailand. In a pilot project, the task of following up ART-receiving patients was shifted from a physician-led HIV clinic team based at district level community hospital, to a nurse-led primary healthcare team of seven primary care centers, based at sub-district level in a district of Chiang Mai in northern Thailand. This study aimed to evaluate the task-shifted ART service in a patient-centered approach. Methodology: Patients' satisfaction level was assessed cross-sectionally in a sample of 198 patients, which included 66 people living with HIV (PLHIV) receiving task-shifted ART service and matched controls in a ratio of 1:2. HIV immunological outcome was compared in a retrospective cohort of a year follow-up. Transculturally translated patient satisfaction questionnaire short form (PSQ-18) was used. Multivariate analysis of variance compared seven domains of patients' satisfaction levels. Results: Community hospital patients expressed significantly higher levels of satisfaction with the technical quality, communication, and time spent by the service provider, whereas the task-shifted model patients experienced significantly better accessibility and convenience of the service. At the one-year follow up, CD4 counts of the two groups were not significantly different. Conclusion: Future research and training programs should aim to improve the technical quality and communication skills of nurse-led ART service teams to shift the task of HIV care and sustain expansion of ART access in primary care settings.

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“…interventions in countries such as Nepal [82,90], Ugunda [117,118] Rwanda [75], Tanzania [50,77], Ethiopia [119], Afghanistan [62] and…”

Section: Discussionmentioning

confidence: 99%

Best Practices in Achieving Universal Health Coverage: A Scoping Review

Koohpayehzadeh

Azami-Aghdash

Derakhshani

et al. 2020

Preprint

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Background: Universal health coverage (UHC) is a very important and effective policy in the health system of countries worldwide. Using the experiences and learning from the best practices of successful countries in the UHC can be very helpful. Therefore, the aim of the present study is to provide a scoping review of successful global interventions and practices in achieving UHC. Methods:The present study is a scoping review study has conducted using the Arkesy and O'Malley framework. To gather information the databases of Embase, PubMed, The Cochrane Library, Scopus, SID and MagIran have searched using the keywords of Universal health coverage, Universal healthcare coverage, Universal health care coverage, Strength*, Transfer*, interventions, improve*, program*, innovations, initiative, Financing, "Service delivery", Stewardship, "Resource generation", from 2000 to 2019. Content-Analysis was also used to analyze the data.Results: Out of 4257 articles, 57 evidence finally included in the study. The results showed that of the 40 countries that had successful interventions, most were Asian. The interventions were financial protection (40 interventions that categorized to 14 items), service coverage (31 interventions that categorized to 7 items), population coverage (36 interventions that categorized to 9 items) and quality (18 interventions that categorized to 7 items) respectively. Also, the successful result were conducted financial protection (14 items), service coverage (7 items), population coverage (9 items) and quality (7 items)) respectively. Conclusion:This study provides a comprehensive and clear view of successful interventions in achieving to UHC. Therefore, with consideration to lessons learned from successful interventions, policymakers can be designing appropriate interventions to their country. a significant impact on health promotion, easier access to health care for those in need, and improved public health, especially for the poor [12].Given the importance of achieving UHC for high-and middle-income countries, the number of countries trying to achieve this has increased in the last two decades [13, 14]. In addition, nowadays countries by increasing their knowledge and awareness of strategies and applying the experiences of successful countries, as well as acquiring the necessary capabilities to meet their urgent needs, are trying to take the path of achieving UHC [15][16][17]. Like other high-income countries that have achieved UHC, low and middle-income countries, with taking into account the structure and resources that they have, on the path to UHC, undertake measures such as mobilizing resources, fulfilling the political commitments necessary to implement health-related policies, and implementing effective reforms and interventions in macro-national policies [1, 18, 19]. The UHC can be one of the most challenging political processes that require the support of various stakeholders, including health system policymakers [4]. Although all countries pursue the same goal of achieving UHC, the path...

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Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage

Cited by 17 publications

References 22 publications

A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research

A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research

Satisfaction of HIV patients with task-shifted primary care service versus routine hospital service in northern Thailand

Best Practices in Achieving Universal Health Coverage: A Scoping Review

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