Influence Of Health Belief Model On Quality Of Retention In Care Of Patients On Antiretroviral Treatment In Bondo Sub County; Siaya County, Kenya

Abstract

The purpose of this study was to establish the influence of Health Belief Model on quality retention in care of patients on antiretroviral treatment in Bondo Sub County; Siaya County, Kenya. The study was carried out in Bondo Sub County and had the following objectives: to assess the patient factors that influence quality retention in care of patients on antiretroviral treatment, to determine social factors that influence quality retention in care of patients on antiretroviral treatment, to establish the influence of drug factors on quality retention in care of patients on antiretroviral treatment, to determine the influence of economic factors on quality retention in care of patients on antiretroviral treatment and to assess the moderating influence of health system factors on quality retention in care of patients on antiretroviral treatment in Bondo Sub County. The target population of the study included County government and partner/MoH supported employees including Volunteer CHVs supporting HIV care and treatment services. A descriptive research design was adopted. Simple random sampling, and purposive sampling techniques were used to select 172 respondents. The study used questionnaires and interview schedule as instruments of data collection. Pilot study was undertaken to ensure validity and reliability of the data collection tool calculated by use of Spearman-Brown Prophesy formula giving a reliability coefficient of 0.86. Data was analyzed qualitatively through content analysis. Quantitative data was first coded then analyzed using Statistical Package for Social Sciences (SPSS) Version 17.0. Data was presented in tables using frequencies and percentages. The findings are that in Bondo sub county, the mean score for the patient factors influencing quality retention of clients on ART was χ =3.79, Social factors (χ = 3.97), drug factors (χ = 4.27), economic factors (χ = 3.80) and health system factors (χ = 4.13). This study concludes that a large proportion of patients initiating ART are poorly retained in care because of patient, social, drug, economic and health system factors. The study explicitly recommends that in order to improve retention, there is huge need to invest in reviewing health education content for specific sub populations, increase knowledge and conversation on retention strategies amongst implementing partners embedded in a personalized CQI approach to mentorship in retention of clients on ART to be scaled up. Stakeholders therefore need to address the cost quality of retaining patients on care or come up with affirmative action to cushion quality of care that on the lowest lead to deaths and lost to follow up as evidenced that shortage of health personnel at the facility is among the drivers of poor retention of patients in care at (χ =4.45) Areas for further research work will include a study on; Impact of NGOs on quality retention in care of patients on antiretroviral treatment, Significance of quality retention in care of patients on antiretroviral treatment to County Government leadership in resources limited settings. This will highlight the issues underlying the challenges of retention in care of patients on antiretroviral treatment and support evidence based and informed decision making in Counties