Hiv/aids Patient Experience and Factors Associated With Satisfaction in Differentiated Service Delivery in Kiambu County

Abstract

Background Differentiated service delivery, a model that was fashioned to address the specific requirements of the continuum of HIV prevention, care and treatment for a sub-type of clients, was rolled out in Kenya in 2016 in response to both health care workers’ and patients concerns. Health care workers were concerned about; high and rising patient workload contributed to by stable clients who did not require frequent clinic visits, quality of care for patients was compromised due to many patient visits in a day and limited resources (space, time, work force). The patients’ concerns were; long waiting time for drug refills, frequent clinic visits even when they did not feel unwell. that could lead to frequent absenteeism from work and possible loss of employment and dissatisfaction with access to treatment. Aim The aim of the study was to assess determinants of patient satisfaction among stable patients enrolled in differentiated service delivery in selected health facilities in Kiambu County. Method The study was a mixed method cross-sectional survey to identify the determinants of satisfaction among stable HIV positive patients enrolled in differentiated service delivery. In the quantitative arm, a structured questionnaire was administered to 404 participants across six health care facilities who were HIV positive male or female patients 20 years and above and had been enrolled in differentiated service delivery. Qualitative data was collected concurrently through Focused Group Discussions (FGDs) systematically selected. Analysis for quantitative data was two pronged; exploratory analysis to get preliminary patterns followed by inferential statistics to analyse relationship between variables of interest. Identified prevailing themes in qualitative arm were then integrated with significant values in quantitative data.

Results High levels of patient satisfaction were reported. Majority of the participants (99%) reported being either satisfied (45%) or being Very satisfied (54%) n=404. Patient knowledge waiting time, savings in time and perception on cost reduction as well as health care worker respect had the strongest associations to satisfaction with differentiated services (P< 0.05). Conclusion Patients enrolled in differentiated service are satisfied with the services offered under the model.