Abstract
Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served; they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.
Highlights
There are approximately 36.7 million people living with HIV in the year 2017-2018, with an estimated 3.8 million individuals newly infected with HIV and about 5000 new infections per day [1]
The findings show that those who received information on self-care primarily from the health workers were 4.3 times likely to utilize integrated HIV and primary health care services (Table 9)
The treatment clients received at the facility influenced utilization of integrated HIV and primary health care services (χ2 = 3.96) whereby those who were treated with respect were 5 times likely to utilize integrated HIV and primary health care services (Table 11)
Summary
There are approximately 36.7 million people living with HIV in the year 2017-2018, with an estimated 3.8 million individuals newly infected with HIV and about 5000 new infections per day [1]. Global goal achievement of zero new HIV infections, zero AIDS-related deaths and zero discrimination has been achieved in most developed countries. Majority of developing countries need more time to achieve the zero new HIV infections goal. They need to be more innovative in treatment, prevention and putting up more programs to be able to achieve the overall goal. Some of the pillars have been put in place to achieve this goal and one of the pillars is to adapt delivery systems This entails decentralisation and integration of HIV care and treatment with other HIV and non-HIV services such as drug dependency services, maternal, new-born and child health or Tuberculosis services. The primary aim of this pillar is to increase community engagement for HIV testing and counselling, care retention and early initiation of ART [2]
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