%0 Journal Article %1 noauthororeditor %A Caroline, %A Micah, %A Moses, %D 2019 %J IJIRIS:: International Journal of Innovative Research in Information Security %K cover cryptography image security steganography %N Issue V %P 108-116 %R doi://10.26562/IJIRIS.2019.JLIS10080 %T HIV PATIENT`S PERCEPTION AND UTILIZATION OF INTEGRATED SERVICES IN EMBU REFERRAL HOSPITAL, KENYA %U http://www.ijiris.com/volumes/Vol6/iss05/01.JLIS10080.pdf %V Volume VI %X Globally, there are approximately 36.7 million people living with HIV, with an estimated 3.8 million individuals newly infected with HIV and about 5,000 new infections per day in the year 2017-2018. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. In Embu teaching and referral hospital, integration of HIV services with other primary health services were initiated in 2014 and up to date, the integration has not been fully adopted by the clients therefore, the study sought to establish the perception of seropositive clients on integrated HIV and primary health care services in Embu Teaching and Referral hospital. A cross sectional survey design was used to collect data from a sample of 302 sero positive clients who were selected using simple random method. A structured and semi-structured questionnaire was used to collect quantitative data while key informant interviews (KII) and Focus Group Discussions (FGDs) helped to collect qualitative data. The tools were reliable at cronbach’s alpha of 0.817 SPSS version 23 was used to analyze the data. Qualitative data from focused group discussions and key informant questionnaire was analysed thematically and theme summaries given under each theme. A binary logistic regression model was used to predict the effect of other determinants of utilization of integrated HIV services and primary health care services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On perception on integrated services 76.5% had a positive perception. Conclusion: Majority of the clients had a positive perception towards the integrated service. They perceived the staff attitude as positive and acknowledged that integration allowed them opportunities to share their life experiences. However, they felt there was need to increase services provided under the integrated arrangement such as cancer screening, TB clinics and other services such as blood pressure monitoring. Recommendation: The Government of Kenya through the Ministry of Health should engage the county government and support from NGO`s to come up with structures and resources needed to expand the facility in terms of facility space and incorporation of other primary health care services like cancer screening, diabetes screening, dental and ophthalmology services.

@article{noauthororeditor, abstract = {Globally, there are approximately 36.7 million people living with HIV, with an estimated 3.8 million individuals newly infected with HIV and about 5,000 new infections per day in the year 2017-2018. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. In Embu teaching and referral hospital, integration of HIV services with other primary health services were initiated in 2014 and up to date, the integration has not been fully adopted by the clients therefore, the study sought to establish the perception of seropositive clients on integrated HIV and primary health care services in Embu Teaching and Referral hospital. A cross sectional survey design was used to collect data from a sample of 302 sero positive clients who were selected using simple random method. A structured and semi-structured questionnaire was used to collect quantitative data while key informant interviews (KII) and Focus Group Discussions (FGDs) helped to collect qualitative data. The tools were reliable at cronbach’s alpha of 0.817 SPSS version 23 was used to analyze the data. Qualitative data from focused group discussions and key informant questionnaire was analysed thematically and theme summaries given under each theme. A binary logistic regression model was used to predict the effect of other determinants of utilization of integrated HIV services and primary health care services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On perception on integrated services 76.5% had a positive perception. Conclusion: Majority of the clients had a positive perception towards the integrated service. They perceived the staff attitude as positive and acknowledged that integration allowed them opportunities to share their life experiences. However, they felt there was need to increase services provided under the integrated arrangement such as cancer screening, TB clinics and other services such as blood pressure monitoring. Recommendation: The Government of Kenya through the Ministry of Health should engage the county government and support from NGO`s to come up with structures and resources needed to expand the facility in terms of facility space and incorporation of other primary health care services like cancer screening, diabetes screening, dental and ophthalmology services.}, added-at = {2019-07-23T19:25:21.000+0200}, author = {Caroline and Micah and Moses}, biburl = {https://www.bibsonomy.org/bibtex/24ccbf9aefc5b487881116eb3e1570991/ijiris}, description = {Globally, there are approximately 36.7 million people living with HIV in the year 2017-2018, with an estimated 3.8 million individuals newly infected with HIV and about 5,000 new infections per day [1]. Among these people 2.1 million are children and teenagers below 15 years of age, most of them from sub Saharan Africa. The vast majority of people living with HIV are in low- and middle-income countries. In 2017, there were 19.6 million people living with HIV (53%) in eastern and southern Africa, 6.1 million (16%) in western and central Africa, 5.2 million (14%) in Asia and the Pacific, and 2.2 million (6%) in Western and Central Europe and North America. Despite implementing some of the preventive measures many people living with HIV or at risk for HIV still do not have access to proper care and treatment [1]. Efforts have been made by the global community to prevent HIV and treat related illnesses. However too many people with or at risk of contracting HIV have no access to care, treatment and prevention [1]. Nevertheless, global goal achievement of zero new HIV infections, zero AIDS related deaths and zero discrimination has been achieved in most developed countries. In Asia and pacific region remarkable progress has been made as indicated by 26% decline in new HIV infections from 2001-2012 and a 46% increase in access to Antiretroviral Therapy (ART) from 2009 to 2012 [2]. Majority of developing countries need more time to achieve the zero new HIV infections goal. They need to be more innovative in treatment, prevention and putting up more programs to be able to achieve the overall goal. Some of the pillars have been put in place to achieve this goal and one of the pillars is to adapt delivery systems. This entails decentralisation and integration of HIV care and treatment with other HIV and non-HIV services such as drug dependency services, maternal, new-born and child health or Tuberculosis services. The primary aim of this pillar is to increase community engagement for HIV testing and counselling, care retention and early initiation of ART [2]. In Sub-Saharan Africa, integration of HIV and family planning services has been shown to have several benefits [3]. These includes services rendered are affordable to clients, reduction of stigma and discrimination. Other studies conducted in South Africa on perception of integration of HIV and sexual reproductive health care, suggested a preference for integrated care among female clients, particularly because of stigma reduction and higher access to contraceptives [4]. Some of the perception of clinicians and clients on integration of primary health care and HIV services showed that about 80% of the respondents were satisfied with integration because the organization of services and confidentiality prevented stigma and discrimination. Majority of participants in the fully and partially integrated facilities reported that clinicians treated them with respect, privacy and confidentiality. Other participants referred staffs as rude and unfriendly, increased waiting time before one is attended to, interruption of consultation which was seen as infringement of privacy. Similar study showed that clients felt that there were delays related to lack of punctuality to report on duty after lunch and tea break, poor staff communication regarding delays in patients consultations like when they break for lunch the staffs do not communicate to the clients [5]. Majority of the respondents in a study conducted in Ethiopia reported positive feelings towards the disease and therefore can disclose their status to their families comfortably and 50% of the respondents mentioned that TB carry the same stigma as HIV, this kind of stigma is reduced when integration of services is embraced.[6].Integration of HIV services and TB treatment demonstrated relative success of integrated and co-located TB/HIV services in Swaziland, and revealed timely ART uptake for HIV-positive TB patients in resource-limited, but integrated settings [7]. A research carried out on patients perception on HIV treatment integration with other services reported that most clients were satisfied with integration of services [8]. However, the clients reported that the staffs’ attitude, number of staffs in health facilities and health care provider, patient communication were significantly affecting patients’ satisfaction levels. In Cameroon integration has led to increased utilization of HIV services, therefore when integration is implemented well and staffs’ attitude and communication improved; patient level of satisfaction was predicted to improve significantly [8]. In Kenya, a study done on experiences of health care providers with integrated HIV and reproductive health services revealed that more clients were satisfied and were willing to uptake HIV testing than in stand-alone clinics. It also revealed that with increased number of clients, infrastructural deficiencies hindered effective delivery of the services as well as limiting quality time for counselling of the patients due to shortage of staffs in relation to high numbers of in flowing clients [4]. Some providers reported that integration enhanced job satisfaction by providing a better quality service, which led to their receiving more regular positive feedback from clients. Collocation of HIV services and primary health care addresses the issue of scarce resource allocation, integration maximizes use of health facility structures and ensures that funds targeted for construction of HIV facilities will also benefit primary health care; therefore both patients can access health care regardless of their HIV status [9]. }, doi = {doi://10.26562/IJIRIS.2019.JLIS10080}, interhash = {065c1034254f19460566ecd9d8e76e5f}, intrahash = {4ccbf9aefc5b487881116eb3e1570991}, issn = {2349-7017}, journal = {IJIRIS:: International Journal of Innovative Research in Information Security}, keywords = {cover cryptography image security steganography}, language = {English, French}, month = {July 2019}, note = {1. UNAIDS. (2018). The Global HIV/AIDS Epidemic. Retrieved August 2018, from hiv.gov: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics 2. Kimberly, G. (2015). HIV service delivery models towards `zero AIDS related deaths. BMC Health service research.15(2) 12-15 3. Johnson, K. (2013). integration of HIV and family planning Health services in Sub-saharan Africa, DHS Analytical studies no. 30 Calverton, Maryland, USA. 4. Mutemwa, R. (2016). Perception and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study. AIDS and behaviour, 20(9), 2130-40. 5. Bergh, A. (2015). Clinician Perceptions and Patient Experiences of ART Teatment and primary health care integration in ART clinics. AOSIS open journa, 38(1),1489l. 6. Sima, Belachew, & Abebe. (2017). Knowledge, Attitude and Perceived Stigma towards Tuberculosis among Pastoralists. Plos one, 12(7), 18-32 7. Pathmanathan, Munyaradzi, Sherri, Dokubo, Preko, Mazibuko, et al. (2017). High Uptake of Antiretroviral Therapy among HIV-positive TB Patients Receiving co-located Services in Swaziland. plos one, 13(5). 196-831 8. Buh, W., Peter, N., & Atashili, J. (2016). Clients satisfaction with HIV treatment services in Bamenda, Cameroon. BMchC Health services Resear, 16(1), 280. 9. Kikuvi, J. (2014). Are integrated HIV services less stigmatizing than stand alone models of care? A comparative case study from Swaziland. International Aids Society. 10. Kioko, J. (2015). Are integrated HIV services less stigmatizing than stand alone models of care? A comparative case study from Swaziland. Journal Of International Aids Society, 16(1), 9-12. 11. National AIDS Control Council,NACC. (2016). Kenya HIV County Profiles. Nairobi: Ministry Of Health 12. Odeny. T, K. J. (2013). Intergration of HIV Core with Primary Health Care services:Effects of patient satisfaction and stigma in Rural Kenya. AIDS Resersch and Treatment, 20(2), 4-8.}, number = {Issue V}, pages = {108-116}, timestamp = {2019-07-23T19:25:21.000+0200}, title = {HIV PATIENT`S PERCEPTION AND UTILIZATION OF INTEGRATED SERVICES IN EMBU REFERRAL HOSPITAL, KENYA}, url = {http://www.ijiris.com/volumes/Vol6/iss05/01.JLIS10080.pdf}, volume = {Volume VI}, year = 2019 }