Caregiver satisfaction with paediatric HIV treatment and care in Nigeria and equity implications for children living with HIV
Identifieur interne : 003881 ( Ncbi/Merge ); précédent : 003880; suivant : 003882Caregiver satisfaction with paediatric HIV treatment and care in Nigeria and equity implications for children living with HIV
Auteurs : Dick Chamla ; Chukwuemeka Asadu ; Ebun Adejuyigbe ; Abiola Davies ; Ebele Ugochukwu ; Lawal Umar ; Ilesanmi Oluwafunke ; Fatimah Hassan-Hanga ; Chinyere Onubogu ; Immaculata Tunde-Oremodu ; Chinelo Madubuike ; Esther Umeadi ; Obed Epundu ; Adenike Omosun ; Emmanuel Anigilaje ; Daniel AdeyinkaSource :
- AIDS Care [ 0954-0121 ] ; 2016.
Abstract
Caregiver satisfaction has the potential to promote equity for children living with HIV, by influencing health-seeking behaviour. We measured dimensions of caregiver satisfaction with paediatric HIV treatment in Nigeria, and discuss its implications for equity by conducting facility-based exit interviews for caregivers of children receiving antiretroviral therapy in 20 purposively selected facilities within 5 geopolitical zones. Descriptive analysis and factor analysis were performed. Due to the hierarchical nature of the data, multilevel regression modelling was performed to investigate relationships between satisfaction factors and socio-demographic variables. Of 1550 caregivers interviewed, 63% (95% CI: 60.6–65.4) reported being very satisfied overall; however, satisfaction varied in some dimensions: only 55.6% (53.1–58.1) of caregivers could talk privately with health workers, 56.9% (54.4–59.3) reported that queues to see health workers were too long, and 89.9% (88.4–91.4) said that some health workers did not treat patients living with HIV with sufficient respect. Based on factor analysis, two underlying factors, labelled
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DOI: 10.1080/09540121.2016.1176682
PubMed: 27392010
PubMed Central: 4991217
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sortKey="Adejuyigbe, Ebun" sort="Adejuyigbe, Ebun" uniqKey="Adejuyigbe E" first="Ebun" last="Adejuyigbe">Ebun Adejuyigbe</name><affiliation><nlm:aff id="AF3"></nlm:aff></affiliation></author><author><name sortKey="Davies, Abiola" sort="Davies, Abiola" uniqKey="Davies A" first="Abiola" last="Davies">Abiola Davies</name><affiliation><nlm:aff id="AF4"></nlm:aff></affiliation></author><author><name sortKey="Ugochukwu, Ebele" sort="Ugochukwu, Ebele" uniqKey="Ugochukwu E" first="Ebele" last="Ugochukwu">Ebele Ugochukwu</name><affiliation><nlm:aff id="AF5"></nlm:aff></affiliation></author><author><name sortKey="Umar, Lawal" sort="Umar, Lawal" uniqKey="Umar L" first="Lawal" last="Umar">Lawal Umar</name><affiliation><nlm:aff id="AF6"></nlm:aff></affiliation></author><author><name sortKey="Oluwafunke, Ilesanmi" sort="Oluwafunke, Ilesanmi" uniqKey="Oluwafunke I" first="Ilesanmi" last="Oluwafunke">Ilesanmi Oluwafunke</name><affiliation><nlm:aff id="AF7"></nlm:aff></affiliation></author><author><name sortKey="Hassan Hanga, Fatimah" sort="Hassan Hanga, Fatimah" uniqKey="Hassan Hanga F" first="Fatimah" last="Hassan-Hanga">Fatimah Hassan-Hanga</name><affiliation><nlm:aff id="AF8"></nlm:aff></affiliation></author><author><name sortKey="Onubogu, Chinyere" sort="Onubogu, Chinyere" uniqKey="Onubogu C" first="Chinyere" last="Onubogu">Chinyere Onubogu</name><affiliation><nlm:aff id="AF5"></nlm:aff></affiliation></author><author><name sortKey="Tunde Oremodu, Immaculata" sort="Tunde Oremodu, Immaculata" uniqKey="Tunde Oremodu I" first="Immaculata" last="Tunde-Oremodu">Immaculata Tunde-Oremodu</name><affiliation><nlm:aff id="AF9"></nlm:aff></affiliation></author><author><name sortKey="Madubuike, Chinelo" sort="Madubuike, Chinelo" uniqKey="Madubuike C" first="Chinelo" last="Madubuike">Chinelo Madubuike</name><affiliation><nlm:aff id="AF5"></nlm:aff></affiliation></author><author><name sortKey="Umeadi, Esther" sort="Umeadi, Esther" uniqKey="Umeadi E" first="Esther" last="Umeadi">Esther Umeadi</name><affiliation><nlm:aff id="AF5"></nlm:aff></affiliation></author><author><name sortKey="Epundu, Obed" sort="Epundu, Obed" uniqKey="Epundu O" first="Obed" last="Epundu">Obed Epundu</name><affiliation><nlm:aff id="AF5"></nlm:aff></affiliation></author><author><name sortKey="Omosun, Adenike" sort="Omosun, Adenike" uniqKey="Omosun A" first="Adenike" last="Omosun">Adenike Omosun</name><affiliation><nlm:aff id="AF10"></nlm:aff></affiliation></author><author><name sortKey="Anigilaje, Emmanuel" sort="Anigilaje, Emmanuel" uniqKey="Anigilaje E" first="Emmanuel" last="Anigilaje">Emmanuel Anigilaje</name><affiliation><nlm:aff id="AF6"></nlm:aff></affiliation></author><author><name sortKey="Adeyinka, Daniel" sort="Adeyinka, Daniel" uniqKey="Adeyinka D" first="Daniel" last="Adeyinka">Daniel Adeyinka</name><affiliation><nlm:aff id="AF2"></nlm:aff></affiliation></author></analytic><series><title level="j">AIDS Care</title><idno type="ISSN">0954-0121</idno><idno type="eISSN">1360-0451</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>ABSTRACT</title><p>Caregiver satisfaction has the potential to promote equity for children living with HIV, by influencing health-seeking behaviour. We measured dimensions of caregiver satisfaction with paediatric HIV treatment in Nigeria, and discuss its implications for equity by conducting facility-based exit interviews for caregivers of children receiving antiretroviral therapy in 20 purposively selected facilities within 5 geopolitical zones. Descriptive analysis and factor analysis were performed. Due to the hierarchical nature of the data, multilevel regression modelling was performed to investigate relationships between satisfaction factors and socio-demographic variables. Of 1550 caregivers interviewed, 63% (95% CI: 60.6–65.4) reported being very satisfied overall; however, satisfaction varied in some dimensions: only 55.6% (53.1–58.1) of caregivers could talk privately with health workers, 56.9% (54.4–59.3) reported that queues to see health workers were too long, and 89.9% (88.4–91.4) said that some health workers did not treat patients living with HIV with sufficient respect. Based on factor analysis, two underlying factors, labelled <italic>Availability</italic> and <italic>Attitude</italic>, were identified. In multilevel regression, the satisfaction with availability of services correlated with formal employment status (<italic>p</italic> < .01), whereas caregivers receiving care in private facilities were less likely satisfied with both availability (<italic>p</italic> < .01) and attitude of health workers (<italic>p</italic> < .05). State and facility levels influenced attitudes of the health workers (<italic>p</italic> < .01), but not availability of services. We conclude that high levels of overall satisfaction among caregivers masked dissatisfaction with some aspects of services. The two underlying satisfaction factors are part of access typology critical for closing equity gaps in access to HIV treatment between adults and children, and across socio-economic groups.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Atun, R" uniqKey="Atun R">R. Atun</name></author><author><name sortKey="Aydin, S" uniqKey="Aydin S">S. Aydin</name></author><author><name sortKey="Chakraborty, S" uniqKey="Chakraborty S">S. Chakraborty</name></author><author><name sortKey="Sumer, S" uniqKey="Sumer S">S. Sumer</name></author><author><name sortKey="Aran, M" uniqKey="Aran M">M. Aran</name></author><author><name sortKey="Gurol, I" uniqKey="Gurol I">I. Gurol</name></author><author><name sortKey="Akdag, R" uniqKey="Akdag R">R. Akdag</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chimbindi, N" uniqKey="Chimbindi N">N. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Care</journal-id><journal-id journal-id-type="iso-abbrev">AIDS Care</journal-id><journal-id journal-id-type="archive">CAIC</journal-id><journal-id journal-id-type="publisher-id">caic20</journal-id><journal-title-group><journal-title>AIDS Care</journal-title></journal-title-group><issn pub-type="ppub">0954-0121</issn><issn pub-type="epub">1360-0451</issn><publisher><publisher-name>Taylor & Francis</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27392010</article-id><article-id pub-id-type="pmc">4991217</article-id><article-id pub-id-type="publisher-id">1176682</article-id><article-id pub-id-type="doi">10.1080/09540121.2016.1176682</article-id><article-categories><subj-group subj-group-type="article-type"><subject>Article</subject></subj-group><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Caregiver satisfaction with paediatric HIV treatment and care in Nigeria and equity implications for children living with HIV</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chamla</surname><given-names>Dick</given-names></name><xref ref-type="aff" rid="AF1"><sup>a</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Asadu</surname><given-names>Chukwuemeka</given-names></name><xref ref-type="aff" rid="AF2"><sup>b</sup></xref></contrib><contrib contrib-type="author"><name><surname>Adejuyigbe</surname><given-names>Ebun</given-names></name><xref ref-type="aff" rid="AF3"><sup>c</sup></xref></contrib><contrib contrib-type="author"><name><surname>Davies</surname><given-names>Abiola</given-names></name><xref ref-type="aff" rid="AF4"><sup>d</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ugochukwu</surname><given-names>Ebele</given-names></name><xref ref-type="aff" rid="AF5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Umar</surname><given-names>Lawal</given-names></name><xref ref-type="aff" rid="AF6"><sup>f</sup></xref></contrib><contrib contrib-type="author"><name><surname>Oluwafunke</surname><given-names>Ilesanmi</given-names></name><xref ref-type="aff" rid="AF7"><sup>g</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hassan-Hanga</surname><given-names>Fatimah</given-names></name><xref ref-type="aff" rid="AF8"><sup>h</sup></xref></contrib><contrib contrib-type="author"><name><surname>Onubogu</surname><given-names>Chinyere</given-names></name><xref ref-type="aff" rid="AF5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tunde-Oremodu</surname><given-names>Immaculata</given-names></name><xref ref-type="aff" rid="AF9"><sup>i</sup></xref></contrib><contrib contrib-type="author"><name><surname>Madubuike</surname><given-names>Chinelo</given-names></name><xref ref-type="aff" rid="AF5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Umeadi</surname><given-names>Esther</given-names></name><xref ref-type="aff" rid="AF5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Epundu</surname><given-names>Obed</given-names></name><xref ref-type="aff" rid="AF5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Omosun</surname><given-names>Adenike</given-names></name><xref ref-type="aff" rid="AF10"><sup>j</sup></xref></contrib><contrib contrib-type="author"><name><surname>Anigilaje</surname><given-names>Emmanuel</given-names></name><xref ref-type="aff" rid="AF6"><sup>f</sup></xref></contrib><contrib contrib-type="author"><name><surname>Adeyinka</surname><given-names>Daniel</given-names></name><xref ref-type="aff" rid="AF2"><sup>b</sup></xref></contrib><aff id="AF1"><label><sup>a</sup></label><institution><named-content content-type="department">Health Section</named-content>,<named-content content-type="institution-name">UNICEF</named-content></institution>,<named-content content-type="city">New York</named-content>,<named-content content-type="state">NY</named-content>,<country>USA</country></aff><aff id="AF2"><label><sup>b</sup></label><institution><named-content content-type="institution-name">NASCP, Federal Ministry of Health</named-content></institution>,<named-content content-type="city">Abuja</named-content>,<country>Nigeria</country></aff><aff id="AF3"><label><sup>c</sup></label><institution><named-content content-type="department">Faculty of Clinical Sciences</named-content>,<named-content content-type="institution-name">Obafemi Awolowo University</named-content></institution>,<named-content content-type="city">Ile-Ife</named-content>,<country>Nigeria</country></aff><aff id="AF4"><label><sup>d</sup></label><institution><named-content content-type="institution-name">Country Office, UNICEF</named-content></institution>,<named-content content-type="city">Abuja</named-content>,<country>Nigeria</country></aff><aff id="AF5"><label><sup>e</sup></label><institution><named-content content-type="department">Department of Paediatrics</named-content>,<named-content content-type="institution-name">Nnamdi Azikiwe University Teaching Hospital</named-content></institution>,<named-content content-type="city">Nnewi Anambra State</named-content>,<country>Nigeria</country></aff><aff id="AF6"><label><sup>f</sup></label><institution><named-content content-type="department">Department of Paediatrics</named-content>,<named-content content-type="institution-name">ABU Teaching Hospital Zaria</named-content></institution>,<named-content content-type="city">Kaduna State</named-content>,<country>Nigeria</country></aff><aff id="AF7"><label><sup>g</sup></label><institution><named-content content-type="institution-name">World Health Organization</named-content></institution>,<named-content content-type="city">Abuja</named-content>,<country>Nigeria</country></aff><aff id="AF8"><label><sup>h</sup></label><institution><named-content content-type="department">Paediatrics Department</named-content>,<named-content content-type="institution-name">Aminu Kano Teaching Hospital/Bayero University</named-content></institution>,<named-content content-type="city">Kano State</named-content>,<country>Nigeria</country></aff><aff id="AF9"><label><sup>i</sup></label><institution><named-content content-type="department">Paediatric HIV and Infectious Disease Unit</named-content>,<named-content content-type="institution-name">Federal Medical Centre</named-content></institution>,<named-content content-type="city">Yenagoa Bayelsa State</named-content>,<country>Nigeria</country></aff><aff id="AF10"><label><sup>j</sup></label><institution><named-content content-type="institution-name">Health Service Commission</named-content></institution>,<named-content content-type="city">Lagos state</named-content>,<country>Nigeria</country></aff></contrib-group><author-notes><corresp id="cor1"><label>CONTACT </label> Dick Chamla <email xlink:href="dchamla@unicef.org">dchamla@unicef.org</email></corresp></author-notes><pub-date pub-type="ppub"><day>26</day><month>5</month><year>2016</year><pmc-comment>string-date: 2016</pmc-comment>
</pub-date><pub-date pub-type="epub"><day>8</day><month>7</month><year>2016</year></pub-date><volume>28</volume><issue>sup2</issue><issue-title>Equity Supplement (sponsored by the Coalition for Children Affected by AIDS)</issue-title><fpage seq="19">153</fpage><lpage>160</lpage><history><date date-type="received"><day>3</day><month>3</month><year>2016</year></date><date date-type="accepted"><day>23</day><month>3</month><year>2016</year></date></history><permissions><copyright-statement>© 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>The Author(s)</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="caic-28-153.pdf"></self-uri><abstract><title>ABSTRACT</title><p>Caregiver satisfaction has the potential to promote equity for children living with HIV, by influencing health-seeking behaviour. We measured dimensions of caregiver satisfaction with paediatric HIV treatment in Nigeria, and discuss its implications for equity by conducting facility-based exit interviews for caregivers of children receiving antiretroviral therapy in 20 purposively selected facilities within 5 geopolitical zones. Descriptive analysis and factor analysis were performed. Due to the hierarchical nature of the data, multilevel regression modelling was performed to investigate relationships between satisfaction factors and socio-demographic variables. Of 1550 caregivers interviewed, 63% (95% CI: 60.6–65.4) reported being very satisfied overall; however, satisfaction varied in some dimensions: only 55.6% (53.1–58.1) of caregivers could talk privately with health workers, 56.9% (54.4–59.3) reported that queues to see health workers were too long, and 89.9% (88.4–91.4) said that some health workers did not treat patients living with HIV with sufficient respect. Based on factor analysis, two underlying factors, labelled <italic>Availability</italic> and <italic>Attitude</italic>, were identified. In multilevel regression, the satisfaction with availability of services correlated with formal employment status (<italic>p</italic> < .01), whereas caregivers receiving care in private facilities were less likely satisfied with both availability (<italic>p</italic> < .01) and attitude of health workers (<italic>p</italic> < .05). State and facility levels influenced attitudes of the health workers (<italic>p</italic> < .01), but not availability of services. We conclude that high levels of overall satisfaction among caregivers masked dissatisfaction with some aspects of services. The two underlying satisfaction factors are part of access typology critical for closing equity gaps in access to HIV treatment between adults and children, and across socio-economic groups.</p></abstract><kwd-group kwd-group-type="author"><title>KEYWORDS</title><kwd>Caregiver</kwd><kwd>satisfaction</kwd><kwd>paediatric HIV</kwd><kwd>equity</kwd></kwd-group><funding-group><funding-statement>The funding for this study was provided by partners as part of their overall support to the NASCP for prevention, treatment and monitoring and evaluation of HIV epidemic and response in Nigeria.</funding-statement></funding-group><counts><fig-count count="1"></fig-count><table-count count="4"></table-count><equation-count count="0"></equation-count><ref-count count="29"></ref-count><page-count count="8"></page-count></counts></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Adejuyigbe, Ebun" sort="Adejuyigbe, Ebun" uniqKey="Adejuyigbe E" first="Ebun" last="Adejuyigbe">Ebun Adejuyigbe</name><name sortKey="Adeyinka, Daniel" sort="Adeyinka, Daniel" uniqKey="Adeyinka D" first="Daniel" last="Adeyinka">Daniel Adeyinka</name><name sortKey="Anigilaje, Emmanuel" sort="Anigilaje, Emmanuel" uniqKey="Anigilaje E" first="Emmanuel" last="Anigilaje">Emmanuel Anigilaje</name><name sortKey="Asadu, Chukwuemeka" sort="Asadu, Chukwuemeka" uniqKey="Asadu C" first="Chukwuemeka" last="Asadu">Chukwuemeka Asadu</name><name sortKey="Chamla, Dick" sort="Chamla, Dick" uniqKey="Chamla D" first="Dick" last="Chamla">Dick Chamla</name><name sortKey="Davies, Abiola" sort="Davies, Abiola" uniqKey="Davies A" first="Abiola" last="Davies">Abiola Davies</name><name sortKey="Epundu, Obed" sort="Epundu, Obed" uniqKey="Epundu O" first="Obed" last="Epundu">Obed Epundu</name><name sortKey="Hassan Hanga, Fatimah" sort="Hassan Hanga, Fatimah" uniqKey="Hassan Hanga F" first="Fatimah" last="Hassan-Hanga">Fatimah Hassan-Hanga</name><name sortKey="Madubuike, Chinelo" sort="Madubuike, Chinelo" uniqKey="Madubuike C" first="Chinelo" last="Madubuike">Chinelo Madubuike</name><name sortKey="Oluwafunke, Ilesanmi" sort="Oluwafunke, Ilesanmi" uniqKey="Oluwafunke I" first="Ilesanmi" last="Oluwafunke">Ilesanmi Oluwafunke</name><name sortKey="Omosun, Adenike" sort="Omosun, Adenike" uniqKey="Omosun A" first="Adenike" last="Omosun">Adenike Omosun</name><name sortKey="Onubogu, Chinyere" sort="Onubogu, Chinyere" uniqKey="Onubogu C" first="Chinyere" last="Onubogu">Chinyere Onubogu</name><name sortKey="Tunde Oremodu, Immaculata" sort="Tunde Oremodu, Immaculata" uniqKey="Tunde Oremodu I" first="Immaculata" last="Tunde-Oremodu">Immaculata Tunde-Oremodu</name><name sortKey="Ugochukwu, Ebele" sort="Ugochukwu, Ebele" uniqKey="Ugochukwu E" first="Ebele" last="Ugochukwu">Ebele Ugochukwu</name><name sortKey="Umar, Lawal" sort="Umar, Lawal" uniqKey="Umar L" first="Lawal" last="Umar">Lawal Umar</name><name sortKey="Umeadi, Esther" sort="Umeadi, Esther" uniqKey="Umeadi E" first="Esther" last="Umeadi">Esther Umeadi</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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