Please join me at the Fifth Global Symposium for Health Systems Research in Liverpool in October 2018. Here is the poster I will be presenting on the ASPIRE Mayuge Project in Uganda. To learn more about the project click here
Wednesday, October 3, 2018
Publication JANAC:Patient Responses on Quality of Care and Satisfaction with Staff After Integrated HIV Care in South African Primary Health Care Clinics
Our latest research on Quality of Care and Satisfaction with Staff in HIV-Integrated Clinics in Free State, South Africa
For full text of the article, please visit the journal's website and find the article here.
To see a draft of the article if you do not have access to the journal click here.
Abstract:HIV care integrated into primary health care (PHC) encourages reorganized service delivery but could increase workload. In 2012-2013, we surveyed 910 patients and caregivers at two time points after integration in four clinics in Free State, South Africa. Likert surveys measured quality of care (QoC) and satisfaction with staff (SwS). QoC scores were lower for females, those older than 56 years, those visiting clinics every 3 months, and child health participants. Regression estimates showed QoC scores higher for ages 36-45 versus 18-25 years, and lower for those attending clinics for more than 10 years versus 6-12 months. Overall, SwS scores were lower for child health attendees and higher for tuberculosis attendees compared to chronic disease care attendees. Research is needed to understand determinants of disparities in QoC and SwS, especially for child health, diabetes, and hypertension attendees, to ensure high-quality care experiences for all patients attending PHC clinics with integrated HIV care.
- May 2018
- Journal of the Association of Nurses in AIDS Care 29(5)
Publication JAIDS:Integrated Hiv-Care into Primary Care Clinics and the Influence on Diabetes and Hypertension Care: An Interrupted Time Series Analysis in Free State, South Africa Over Four Years
What happens to NCD care when HIV-care is integrated into Primary Health Care Clinics? Read more to find out.
To access the full text of this article, please visit the journal's website here.
If you do not have access to the journal, please read a draft version here.
Abstract:Background: Non-communicable diseases (NCDs), specifically diabetes and hypertension, are rising in high-HIV burdened countries like South Africa. How integrated HIV-care into primary health care (PHC) influences NCD care is unknown. We aimed to understand whether differences existed in NCD care (pre versus post-integration) and how changes may relate to HIV patient numbers. Setting: Public-sector PHC clinics in Free State, South Africa METHODS:: Using a quasi-experimental design, we analysed monthly administrative data on four indicators for diabetes and hypertension (clinic and population levels) during four years as HIV-integration was implemented in PHC. Data represented 131 PHC clinics (PHCCs) with a catchment population of 1.5 million. We utilised interrupted time series analysis at ±18 and ±30 months from HIV integration in each clinic to identify changes in trends post-integration compared to pre-integration. We utilised linear mixed effect models to study relationships between HIV and NCD indicators. Results: Patients receiving ART in the 131 PHC clinics studied increased from 1614 (April 2009) to 57, 958 (April 2013). Trends in new diabetes patients on treatment remained unchanged. However, population level new hypertensives on treatment decreased at ±30 months from integration by 6/100, 000 (SE=3,p<0.02) and was associated with the number of new HIV patients on treatment at the clinics. Conclusion: Our findings suggest that during the implementation of integrated HIV-care into PHCCs care for hypertensive patients could be compromised. Further research is needed to understand determinants NCD care in South Africa and other high HIV-burdened settings to ensure patient-centred PHC.
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