Abstract
BackgroundThe HIV epidemic poses significant challenges to the low income countries in sub Saharan Africa (SSA), affecting the attrition rate among health care workers, their level of motivation, and absenteeism from work. Little is known about how to deal with deterioration of human resources in the health care systems. This study aimed to predict the intention to provide surgical treatment to HIV infected patients among medical- and dental students in Tanzania and Sudan using an extended version of the Theory of Planned Behaviour (TPB).MethodsFour hundred and seventy five medical- and dental students at the University of Dar es Salaam (mean age, 25 yr) and 642 dental students attending 6 public and private dental faculties in Khartoum (mean age 21.7 yr) completed self-administered TPB questionnaires in 2005 and 2007, respectively.ResultsBoth Tanzanian and Sudanese students demonstrated strong intentions to provide care for people with HIV and AIDS. Stepwise linear regression revealed that the TPB accounted for 51% (43% in Tanzania and Sudan) of the variance in intention across study sites. After having controlled for country and past behaviour, the TPB in terms of attitudes, subjective norms and perceived behavioural control accounted for 34% and moral norms for an additional 2,3% of the explainable variance in intention. Across both study sites, attitudes were the strongest predictor of intention followed in descending order by subjective norms, moral norms and perceived behavioural control.ConclusionThe TPB is applicable to students' care delivery intentions in the context of HIV and AIDS across the two SSA countries investigated. It is suggested that attitudes, subjective norms, moral norms and perceived behavioural control are key factors in students' willingness to treat AIDS and HIV infected patients and should be targets of interventions aimed at improving the quality of health care delivery in this context.
Highlights
The HIV epidemic poses significant challenges to the low income countries in sub Saharan Africa (SSA), affecting the attrition rate among health care workers, their level of motivation, and absenteeism from work
Measurement model for the extended Theory of Planned Behaviour (TPB) CFA indicated that an initially proposed 4-factor model specified for the extended TPB questionnaire was not an acceptable fit on any indices employed, neither with the Tanzanian (χ2 = 308,057, df = 84, comparative fit index (CFI) = 0.91, root-mean-squared error of approximation (RMSEA) = 0.07, AIC = 380.0) nor with the Sudanese data (χ2 = 351,398, df= 84, CFI = 0.89, RMSEA = 0.07, AIC = 453.3)
This appears to imply that the four constructs underlying the TPB questionnaire are discrete measures that can be reliably assessed in Tanzanian and Sudanese students and that those measures can be reported as four summary scores
Summary
The HIV epidemic poses significant challenges to the low income countries in sub Saharan Africa (SSA), affecting the attrition rate among health care workers, their level of motivation, and absenteeism from work. An estimated 22 million people were living with HIV and AIDS in sub-Saharan Africa, SSA, at the end of 2007 [1]. The United Republic of Tanzania had an estimated 1.6 million people living with HIV and AIDS as of the end of 2003 [1]. The HIV epidemic poses significant development challenges to the low income countries in SSA [2]. It affects the attrition rate among health care workers, their level of motivation, professional practices and absenteeism from work [2]. Little is known about how to deal with the deterioration of human resources in the health care systems
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