Determinants of Access to Comprehensive Care Centre Services among Hiv/Aids Patients in Mandera County, Kenya
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Date
2024-09
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Kenyatta University
Abstract
Human immunodeficiency virus (HIV) is a major public health problem in many parts
of the world. Kenya has the fourth-largest HIV epidemic in the world. Mandera County
is part of north eastern province of Kenya. The county has poor infrastructure and
inaccessible health facilities. Only 30% of the residents live around a health facility.
The County has low HIV testing prevalence with residents associating HIV with
immorality and highly stigmatized. Retention to ART care is 68% against the national
target of 90%. The County has only 10 CCC distributed within 7 sub-counties serving
a population of 867,457. The main objective of the study was to determine the
determinants related to access of CCC services among HIV/AIDS patients in Mandera
County. The study was cross-sectional which involved interviewing patients in Mandera
County using a structured questionnaire. It was carried out between August and October
2021 and participants were recruited from five CCC in Mandera East sub county. The
interviewees were picked randomly from CCC patients visiting the hospital and those
defaulted. The data was entered in a data collection form and analyzed using SPSS
version 20 under strict ethical considerations to ensure patients’ confidentiality were
safeguarded. Descriptive statistics included frequencies and percentages while
inferential statistics included cross tabulations and chi square tests for associations
testing of the independent against dependent variables. The chi-square was tested at
p≤0.05 significance level. Results revealed that most of the respondents 38.7% aged
between 35-39 years out of 336 respondents, 60.4% were male, 44.1% were married,
33.9% had secondary level of education, 75.9% had informal occupation and 84.8%
were from Mandera East Sub-County. There was a significant relationship between age group P<.001, level of education P<.001, occupation P<.001, residence P=0.048, source
of income P<.001, employment status P<.001, nature of employment P<.001, category
of earning P<.001, means of transport to the facility P<.001, healthcare workers’ attitude
P=0.023, provision of incentives P=0.002, compliance to instructions P<.001, perceived
stigma from healthcare workers P=0.01 and access to CCC services in Mandera County.
It is concluded that there is significant relationship between determinants and access to
CCC services therefore it recommended that the determinants affecting access that can
be modified and corrected by the healthcare workers at the facility level like stigma,
attitude and provision of incentives to be corrected in order to increase access to CCC
services in Mandera County. The County to formulate policies in conjunction with the
national government and implementing partners on the ground to address and formulate
targeted interventions.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University September, 2024
Supervisor:
1. Justus O.S Osero
2. Washington Arodi