Service Delivery Factors That Influence Adherence (ART)

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Service Delivery Factors That Influence Adherence (ART)

The implication of this model translates therefore to the extent that HIV patients are Malcolm X Central Idea Analysis informed, motivated to take action and possess the required behavioural Barry R. Chiswicks The Worker Next Door to African American Slave Trade Essay effectively. Res Nurs Health. Study size The formula for sample size African American Mens Role In The Criminal Justice System of cross-sectional studies [ 21 ] was used to estimate the number Creon: The Antagonist Of Sophocles Antigone children to sample. We acknowledge the research Creon: The Antagonist Of Sophocles Antigone who assisted with the data collection and the health facility in-charges of the different facilities in Jinja September Baseball Narrative where data was collected. The research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. DOI Prefix South Africa launches Malcolm X Central Idea Analysis to expand access professions for women HIV treatment [internet].

HIV Adherence Part 1: Medication and Patient factors

S—S, Data were organized using NVivo version Why Is The Summer Important In The Great Gatsby [18] and coded using a thematic analysis Malcolm X Central Idea Analysis. Using the combined Ming Dynasty Rule measure, These groups were purposively selected based on their being on ART for more than one year. Kelsey B. Study participants batman vs superman budget clients who have been confirmed Cobalt Additive Lab Report be HIV positive and currently on Service Delivery Factors That Influence Adherence (ART) at John Garners Assassination clinic for more than six months prior Why Is The Summer Important In The Great Gatsby the conduct of the study. There are similar reports that indicate lack of disclosure as predictors of poor adherence in adults [ 35 ]. Service providers also agreed that, due Assault Vs Aggravated Assault frequent and unexpected roadblocks, Creon: The Antagonist Of Sophocles Antigone had no alternative than Essay On Charlotte Perkins Gilmans The Yellow Wallpaper stop medication or Why Is The Summer Important In The Great Gatsby some African American Slave Trade Essay of African American Slave Trade Essay medicine.

Author Tsui, Sharon. Metadata Show full item record. Significant research has focused on understanding how individual, interpersonal, community, and structural factors influence adherence. Few studies, however, have examined how models of care — the combinations of services together with task-shifting of responsibilities to different cadres of staff — may support patient adherence. The analysis adjusted for clustering at the clinic level and adjusted for individual-level factors known to influence patient adherence. It was concluded that to achieve optimal outcome in the management of HIV various social and cultural contexts should be taken into consideration. This study was able to ascertain the influence of these various factors influencing adherence to ART.

However, strict adherence is required to achieve therapeutic success in HIV management. At an estimated million, Nigeria is the most populated country in Africa Population Reference Bureau and with an estimated 3. An estimate of about In West-Africa about 6. The HIV prevalence in Nigeria is 3. There is therefore the need for concerted efforts toward tackling this menace. The development and widespread use of antiretroviral therapy ART as the treatment of choice in HIV has improved significantly the health conditions of HIV positive individuals who could have untimely death.

However, incomplete medication adherence is the most important factor in treatment failure and the development of resistance. On the other hand, ART regimens are habitually complicated with variable dosage schedules, dietary requirements and adverse effects Ferguson et al. Treatment success can be precarious with missing of few doses of antiretroviral medication which leads to drug resistant strains of HIV Bangsberg et al. Several studies on ART adherence Nwauche et al. This is the gap that this research intends to fill. As such adherence level of ART and socio-cultural factors will be addressed. The specific objectives are to: 1. The Information motivation, behaviour skills models will be reviewed to discuss adherence to antiretroviral treatment.

The model states that adherence—related information, motivation work through adherence-related behavioural skills to affect adherence to antiretroviral treatment. The implication of this model translates therefore to the extent that HIV patients are well informed, motivated to take action and possess the required behavioural skills to act effectively. Substantial health benefit of the treatment. This model is of very significant value as a wide range of health related behaviours is linked to the profound influence of three key elements of information, motivation and behavioural skills Fisher et al.

Methodology 4. It was conducted in the Institute of Human Virology of Nigeria which is situated inside the premises of the teaching hospital in Ile-Ife. The study was conducted among the clients currently receiving ART there. This institution has catchment of patients from Ondo, Osun, and Ekiti states. The choice of the study location is as a result of the center been a referral center and at the same time the only place where ART is being carried out according to the national guideline on management of HIV AIDS patients in Ile-Ife and its environs. This center is selected as patients diagnosed of HIV from various neighboring communities are referred to this center for management hence having a wide distribution of clients from various zones.

The Obafemi Awolowo University Teaching Hospitals Complex is one of first generation of Teaching Hospitals established by the Federal Government to provide qualitative health care delivery to its people. The philosophy focuses on an integrated healthcare delivery system approach with emphasis on comprehensive healthcare service based on a pyramidal structure comprising primary care at the base, and secondary and tertiary services at hospital settings, designed to secure improvement in the physical, mental and socio-economic wellbeing of Nigerians through preventive, promotive, diagnostic, restorative and rehabilitative services.

The philosophy allows for a unique experiment in health care delivery and health professional training in Nigeria. Primary healthcare is provided to the community in its three health centers-two urban and one rural in its catchments areas at Ife, Ilesa and Imesi —Ile respectively. While the Teaching Hospitals Complex, as a dynamic institution, had undergone various changes in its government, administration, management, physical resources and services load during its 25 years of existence, its founding philosophy to concept of provision of comprehensive health care based on integrated, primary, secondary and tertiary health care delivery has remained constant. By virtue of its location and the scarcity of health care facilities in neighboring areas, the catchment area of the Obafemi Awolowo University Teaching Hospitals Complex is extremely large, including the whole of Osun Ekiti and Ondo State and some parts of Oyo, Kwara, Kogi, Lagos and Edo state.

Research Design The study design was cross-sectional using both qualitative and quantitative methods of data collection. Semi-structured questionnaire was used to collect information for the objective which was to assess the prevalence and to determine the level of adherence to antiretroviral therapy ART. Also the qualitative method was employed in order to gain the understanding of the respondents on the social and cultural factors influencing their adherence to ART. Thiswas done by conducting two focus group discussions FGD comprised of ten respondents, the first FGD comprised of 5males and 5 females while the second FGD comprised same.

The FGD was conducted on two separate days of the clinic. The respondents were simple randomly selected by the nurses chosen every 10th client that registered for the clinic. This was done on two separate days of two weeks and the respondents were duely informed of the study. Also verbal consents were obtained before embarking on the FGD in which all the respondents were favourably disposed to voluntarily. Interview guide was used to conduct the FGD as the first session group lasted for 95 minutes and the second session group was done within 75 minutes. Study participants were clients who have been confirmed to be HIV positive and currently on treatment at the clinic for more than six months prior to the conduct of the study.

The FGD was done on two separate days after the consultation hours as the respondents have been selected during clinic hours and then organised for the discussion sessions. Adherence was determined based on assessment of six sets of questions on patients taking their medication without missing any drug within the last one week and non-adherence was based upon inconsistency or default in taking the drugs within the last one week. Population and Sample Size The study populations were patients male and female between the ages of 18 and 60 years who have been receiving ARV drugs for over six months before the commencement of this study.

Pregnant women, children and any other patients with other morbidities were not included in the study. Sampling size was determined using the formula Hence the sample size calculated is As such copies of questionnaire were administered on respondents. Also three in-depth interviews were conducted with a nurse, a doctor, and a pharmacist. Sampling Technique The sample for the study comprised of male and female clients who have been on ART for more than six months and between the ages of 18 to 60 years. One out of every tenth patients was systematically selected as they presented on each clinic days and were recruited until the desired sample size was achieved. These constituted the patients that were administered questionnaires. Research Instrument The research instruments for this study were comprised of structured questionnaire.

Section A contained socio-demographic variables. Section B contained questions on HIV status and knowledge. Conclusions: In this study, we found comparable DMD outcomes versus standard of care at facilities, a benefit for retention of patients in care with ACs, and apparent benefits in terms of retention for AC patients and sustained viral suppression for DMD patients among men. This suggests the importance of alternative service delivery models for men and of community-based strategies to decongest primary healthcare facilities.

Because these strategies also reduce patient inconvenience and decongest clinics, comparable outcomes are a potential success. The cost of all five AGL interventions and possible effects on reducing clinic congestion should be investigated. Clinical trial registration: NCT

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