Assessment of HIV-positive postnatal clients’ satisfaction with prevention of mother-to-child transmission services at Kenyatta National Hospital, Nairobi, Kenya
Gikonyo, Jackson Mwaniki
MetadataShow full item record
In the era of HIV and AIDS global pandemic, clients‟ satisfaction is one of the outcome measures for the free PMTCT services and HIV/AIDS care.Despite increasing availability and accessibility to free PMTCT services in Kenya, there is inadequate information on clients‟ satisfaction with PMTCT services.This study aimed at establishing the levels of HIV- positive postnatal clients‟ satisfaction with PMTCT services offered in post pregnancy clinic atKenyatta National Hospital, possible influencing factors and improvement strategies to enhance achievement of desired clients‟ satisfaction. A descriptive cross sectional study was conducted for HIV-positive postnatal clients. A simple random sampling was used to obtain 139 participants at service exit after consideringformulated eligibility criteria (exclusion and inclusion).Quantitative data was collected by use of in-depth exit interviews and focus group discussions. Data was processed using SPSS software version.22 to test hypothesis and explain relationships.Results were considered significant when p-value was equal or less than 0.05.The results revealed that integrated PMTCT services were offered in every clinic appointment.Results from Chi-square test were further confirmed by use of logistic regression analysis that showed that; waiting time (p<0.01), resources and infrastructure (p<0.01), clients‟ level of knowledge of HIV (p<0.01), health providers‟ attitudes (p<0.01), provider-client communication (p<0.01), psychosocial support and stigma (p<0.01) were found to have influenced clients‟ satisfaction with the PMTCT services.The study findings enabled the rejection of null hypothesis and adoption of alternative hypothesis. Overall, the study results revealed that majority (86/139) of the respondents were satisfied with PMTCT services offered while more than one third of the respondents (53/139) were dissatisfied. Clients‟ satisfaction was associated with staff understanding of clients‟ needs, desires, expectations and concerns, quality of services or care received,adequate counseling,strong psychosocial support servicesand quality laboratory services. The clients‟ dissatisfaction was associated with long waiting time, delayed laboratory investigations, pharmacy being located far from the clinic, high cost incurred when travelling to seek for PMTCT services from their residential zones, inadequate privacy and confidentiality etc.The study yielded a range of new insights on strategies for achieving desired satisfaction with PMTCT services such as reduction of waiting time, performance and quality improvement, improved infrastructure and supply of relevant resources, improved integration and organization of relevant services such as partner involvement, child healthcare, HIV testing services etc. The improvement strategies will enhance efficiency and effectiveness in provision of PMTCT services as indicated in the national guidelines.The study recommends that stakeholders of PMTCT program embrace and implement the proposed improvement strategies, facilitate similar studies in future throughout the country to identify experiences, service quality gaps and model best practices for sharing among stakeholders to strengthen PMTCT program in the country.