Health Facilities Research Articles

Exploring the Health Care Seeking Behavior of Rohingya Community during COVID-19 Pandemic

Introduction: COVID-19 was declared a 'pandemic,' and it was the most horrific diseases the world. Objective: The study aimed to explore the healthcare-seeking behavior of Rohingya people during the COVID-19. Materials and methods: It was conducted as a cross-sectional study involving a sample size of 200 participants. Respondents were chosen through convenience sampling methods. The study population was the Rohingya population residing in Cox’s Bazar. A well-designed and pretested set of structured questionnaires was used to collect the information. The total study duration was for 3 months. Informed consent was taken from the participants, and Ethical clearance was taken from the IRB of AIUB. Data were analyzed using IBM STATA 16. Place and period of study: The study was conducted at Cox’s Bazar Rohingya Camp in Bangladesh. Results Majority (40%) of the respondents was aged between 30 to 49 years and 51% of them were female. A significant majority, 88%, expressed a preference for treatment at a Refugee health camp, while 9% opted for a Pharmacy and 3% chose a Traditional healer. Overall, 88% of respondents demonstrated positive behavior, in contrast to 12% who exhibited negative behavior. The results of a multivariate logistic regression analysis indicated that factors such as low educational attainment, fear of visiting health facilities, and a lack of awareness regarding COVID-19 prevention were significantly associated with negative health-seeking behavior. Conclusion: The healthcare-seeking behavior exhibited by the Rohingya community in Bangladesh during the COVID-19 pandemic has been observed to be commendable.

Community responses and adaptations following the closure of a rural pharmacy and primary care facility

AbstractPurposeThis study investigates the experiences of one rural community in Central Pennsylvania following the closure of its singular pharmacy and primary health care facility. It aims to understand community members’ responses and adaptations to declining health care accessibility and broader implications for rural health policy and practice.MethodsEmploying a qualitative case study design, researchers conducted 26 in‐depth interviews from May to December 2022. Interviews were grounded in a phenomenological approach and focused on participants’ perceptions of their community and experiences accessing health care. Data were analyzed thematically following a coding reliability approach.FindingsThe closure of the health care facilities resulted in significant social and economic impacts, particularly among vulnerable groups, such as older adults, people with disabilities, and working‐class families. Participants reported increased reliance on their social support networks to access care, delays in seeking care due to the strain from longer travel distances, and loss of familiar and trusted care providers. We also found an over‐reliance on local emergency medical services for routine care. Although the community demonstrated resilience through the use of social networks, some adaptations carried health risks, including delayed care and unmonitored use of alternative remedies.ConclusionsThis study highligths the need for health care policies that address the immediate loss of services and support the social networks and economic stability that rural communities rely on in the absence of local health care facilities. This research contributes insights for policymakers, health care providers, and community leaders working to support rural communities facing similar health care losses.

Exploring determinants of basic childhood vaccination coverage in Bangladesh: a generalized Poisson regression analysis

IntroductionChildhood vaccination is crucial for safeguarding children against potentially life-threatening diseases. This study aims to investigate the significant factors influencing vaccination coverage among children aged 12–59 months in Bangladesh.MethodsThe study utilizes cross-sectional data from the 2017–18 Bangladesh Demographic and Health Survey. A Kruskal–Wallis test is employed in bivariate analysis to identify significant predictors associated with childhood immunizations. A generalized Poisson regression model is applied to assess the impact of various risk factors on children’s incomplete vaccination status.ResultsChildren born in the Sylhet division show lower chances of receiving immunizations. Additionally, children whose mothers are younger, have no education or only primary education, and are unemployed, are less likely to be fully vaccinated. Furthermore, children born into smaller families, first birth, those whose mothers had access to media, and those who received more than four antenatal visits during pregnancy are more likely to have received all recommended vaccines.ConclusionImplementing targeted interventions to improve childhood vaccination coverage, particularly among vulnerable populations such as young and uneducated mothers with middle-income status, is crucial. Enhancing media access, promoting the utilization of antenatal care at health care facilities, and raising awareness about the benefits of vaccination can help ensure optimal vaccination coverage among children in Bangladesh.

Exploring harmful traditional practices and its associated factors among puerperal mothers who delivered in public health facilities in southwestern Ethiopia

Harmful traditional practices are deeply ingrained beliefs and behaviors within a society that significantly impact the well-being of mothers and children. In Ethiopia, there is limited awareness and comprehension concerning the prevalence of harmful traditional practices in the puerperal period. The underlying reasons for engaging in harmful cultural practices during this period at the community level remain inadequately studied. The main aim of this research is to investigate the prevalence of harmful traditional practices during the puerperal period and its associated factors in public health facilities of southwestern Ethiopia, 2023. A mixed-methods community-based cross-sectional approach was undertaken from June 1st to July 31st, 2023. The study utilized the 24 kebeles in the Ilubabor and Buno Bedele Zones of Southwest Ethiopia. Three hundred twenty puerperal mothers in selected kebeles found in Ilubabor and Buno Bedele zones met inclusion criteria during the data collection period. We used a pretested semi-structured questionnaire, supplemented by in-depth interviews and focused group discussions with purposively selected 18 mothers. We utilized backward multiple logistic regressions were utilized to evaluate the interplay between various factors, with statistical significance set at a P-value below 0.05. This finding disclosed that the prevalence of harmful traditional practices during the puerperal period was 76.3%. Factors such as educational status (AOR = 3.47, CI = 1.57–9.27), rural residency (AOR = 2, CI = 1.51–4.88), absence of antenatal care in the last pregnancy (AOR = 6.42, CI = 2.33–8.74), and the place of delivery for the most recent child (AOR = 1.7, CI = 1.15–4.07) were significantly associated with these practices. The findings underscore a substantial prevalence of harmful traditional practices among mothers during the puerperal period. It is imperative for the Zonal Health department, in collaboration with relevant stakeholders, to actively combat these practices within rural communities and healthcare facilities.

Leadership best practices for improving engagement and burnout in health facilities: A positive deviance approach from the Veterans Health Administration.

Leadership best practices for improving engagement and burnout in health facilities: A positive deviance approach from the Veterans Health Administration.

Perinatal care in the earthquake disaster of the century: Nurses’ and midwives’ experiences

AbstractAimTo determine the experiences of nurses and midwives providing perinatal care in an earthquake area.BackgroundOn February 6, 2023, two earthquakes measuring 7.8 and 7.6 magnitudes struck Turkey, affecting a large area. It is crucial for perinatal care to be rapidly organized, provided under the most suitable conditions, and delivered by qualified health professionals. Understanding the post‐disaster experiences of nurses and midwives is crucial to addressing this issue.MethodThis is a qualitative study using phenomenological methodology with 8 nurses and 12 midwives in the earthquake‐affected area. Personal information and semistructured interview forms were used for data collection. Content analysis was used for data analysis.ResultsParticipants had a mean age of 33.75 years. The experiences of nurses and midwives were grouped into five themes: emotions experienced, challenges encountered, problems in perinatal services, coping mechanisms, and recommendations. The emotions experienced theme encompasses both positive and negative emotions. The challenges encountered theme includes challenging environmental conditions, organizational issues, problems with medical supplies and drugs, and being a victim of the earthquake. The problems in perinatal services theme includes pregnancy, childbirth, and postpartum services. The coping mechanism's theme encompasses problem‐focused and emotion‐focused coping strategies. The recommendations theme includes education and awareness, preparedness for disasters, and sustainable services.Implications for nursing/midwifery and health policyNurses and midwives working in the earthquake‐affected area experienced numerous physical and psychological challenges and encountered difficulties in delivering health services. A disaster education course including simulated disaster drills and practice can be integrated into the education system. Strengthening healthcare facilities against disasters and raising awareness among the community are crucial.

Spatial-Temporal Distribution of 12-Year Periodontal Disease Prevalence in a Large Population Using Geographical Information Systems: A Longitudinal Study.

Periodontal diseases, commonly linked to dental biofilm and affecting adults, were studied using Geographic Information Systems (GIS) and Kernel Analyses with epidemiological data. This paper presents a hybrid method for use in epidemiological studies by evaluating the spatiotemporal distribution of disease prevalence. This study analy ed 47,757 patients from the Department of Periodontology out of 662,351 visitors to University Faculty of Dentistry (2012 to July 2023). The central districts of Kayseri in Turkey were selected as the study areas. Periodontitis prevalence was assessed through radiographic evidence and clinical examination. Point-based location data, including gender, age, and disease type, matched household data, creating building-based spatial data. Kernel Density (KD) and Average Nearest Neighbor (ANN) analyses examined patient concentration and disease types in specific regions. Accordingly, standard deviation ellipses were prepared by year to assess the spatial changes in the regions where patients resided. The study found higher periodontitis prevalence in males, increasing with age, while gingivitis decreased. After 2017, periodontitis prevalence notably declined. Location-based data exhibited clustering in patient distribution. KD maps showed similar patient distributions over the years, with more applications from areas closer to the Faculty of Dentistry. The spatial distribution of the patients applying has remained consistent over the last 5 years. Through GIS, KD maps reveal the spatial-temporal distribution of periodontitis patients. This aids in identifying high-prevalence regions and guiding strategic healthcare facility placement. Implementing preventive programs in high-demand areas, particularly in family health centers (local health facilities), can reduce community-wide periodontal disease prevalence.

Patterns of handwashing among healthcare workers in APIN Public Health initiatives supported states in Southwest Nigeria

BackgroundEffective hand hygiene is crucial for preventing healthcare-associated infections (HAIs) among healthcare workers (HCWs) and patients. This study aimed to assess handwashing practices among HCWs providing routine HIV care to People Living with HIV (PLHIV) and to compare hand hygiene patterns among clinical and non-clinical health workers in APIN Public Health Initiatives-supported states in Southwest Nigeria.MethodsA cross-sectional study was conducted among HCWs providing routine HIV care to PLHIV in selected healthcare facilities across APIN-supported states (Oyo, Ogun, and Ondo) from January to June 2024. Data on handwashing patterns and compliance factors were collected using a semi-structured questionnaire. A total of 588 respondents were recruited using multi-stage stratified cluster sampling. Descriptive analysis was performed, hand hygiene patterns among clinical and non-clinical health workers were compared, and chi-square statistics determined the associations, with a p-value of < 0.05 considered significant.ResultsThe study found that 56.5% of participants had good awareness of handwashing practices, and 54.6% demonstrated good compliance. Additionally, 65.5% reported washing hands before and after routine activities. Handwashing awareness (60.3%) and compliance (60.5%) rates were highest among clinical professionals. Major barriers to handwashing included inadequate water supply, lack of materials, being too busy, and forgetfulness. Profession was significantly associated with hand hygiene awareness (odds ratio [OR] = 1.504, confidence interval [CI] = 1.075–2.104), while age (OR = 0.613, CI = 0.442–0.851) and profession (OR = 1.888, CI = 1.347–2.645) were significantly associated with compliance.ConclusionThe study highlights suboptimal handwashing practices among healthcare workers, with non-clinical workers demonstrating lower awareness and compliance to hand hygiene standards compared to clinical staff despite working in the same environment. Therefore, future tailored training sessions and interventions should be prioritized for non-clinical health workers.

Mortality in people with mental disorders in Poland during the COVID-19 pandemic: a nationwide, register-based cohort study

Purpose of review People with mental disorders in Poland have increased standardized mortality ratios (SMRs). This is the first study to assess all-cause mortality in people with mental disorders in Poland during the COVID-19 pandemic. Recent findings A nationwide, register-based cohort study utilizing data from the registry of healthcare services (2011–2020) and the all-cause death registry (2021) in Poland was conducted. Individuals who were consulted or hospitalized in public mental healthcare facilities and received at least one diagnosis of mental disorders (ICD-10) from 2011 to 2020 were identified. SMRs were compared between people with a history of mental disorder and the general population. SMRs for the pandemic period were also compared with prepandemic SMRs calculated for 2019. No significant differences in SMRs were observed overall between 2021 and 2019. A minor increase in SMR was observed in 2021 for people treated only in outpatient mental health clinics. In 2021, a significant decrease in SMRs was shown for individuals with diagnoses from groups F10-F19 and F20-F29, and a significant increase in SMRs was observed for those with diagnoses from group F40-F48. Summary SMRs for people with any mental disorder in Poland in 2021 remained at comparable levels to those in 2019.

Routine HPV vaccination: Reflection on delivery strategies based on countries’ experiences

Despite the introduction of the human papillomavirus (HPV) vaccine in many low- and middle-income countries (LMICs), countries are still struggling to maintain HPV vaccination coverage and manage sustainable delivery strategies. This article explores the challenges and effective strategies for HPV vaccine delivery in LMICs, with a focus on reflecting upon current HPV vaccine delivery strategies in the World Health Organization (WHO) HPV vaccine introduction guidelines to align with practical implementation experiences. The article utilizes presentations and discussions from Coalition to Strengthen the HPV Immunization Community (CHIC) symposia, field experiences of program implementers who participated in the meeting and immunization expert opinions, to inform its findings. Several countries are spotlighted for their delivery strategies. These include routinized campaign mode vaccinations at schools in The Gambia, Zambia, and Ethiopia; routine health facility services in Tanzania, Kenya, and Maldives; and outreach strategies targeting out-of-school girls. By evaluating these diverse strategies, the article suggests a need to delve deeper and build an understanding of the routinized campaign mode of HPV vaccine delivery, and advocates for expanding the scope of delivery strategies and consequently updating the WHO HPV vaccine delivery guidelines in line with the evolving landscape of HPV vaccination delivery to ensure comprehensive, cost-effective, and sustainable programs in LMICs.

Identifying key challenges and optimizing approaches for training of health care professionals for HPV vaccination programmes

Healthcare professionals (HCPs) play a crucial role in building vaccine confidence and promoting vaccination programmes. HCP vaccination recommendations are often the strongest predictor of vaccine uptake, influencing individuals' acceptance of and demand for vaccination. However, HCP training on human papillomavirus (HPV) vaccination faces challenges in some countries, including Ethiopia, Malawi, and Uganda. This study summarizes the discussions held during the Coalition to Strengthen HPV Immunization Community Symposium in Africa, the field experiences of co-authors, and expert opinions to inform its findings. Key challenges faced in these countries are maintaining regular and comprehensive HCP training, ensuring continuity due to staff turnover, reaching all health facilities, and including teachers as key mobilizers. Funding constraints, limited communication materials, and human resource shortages can further impact training effectiveness. Recommendations for strengthening HCP training on HPV vaccination programmes include providing adequate training to all HCPs, refresher training, including private sector HCPs and teachers, leveraging local training institutions, and integrating HPV vaccine training into pre-service HCP academic curricula. These actions would be essential for improving HPV vaccine coverage and working towards cervical cancer elimination goals.

Enhancing Indoor Environmental Quality in Ghanaian Public Health Facilities: Challenges and the Role of Automation Technologies

Enhancing Indoor Environmental Quality in Ghanaian Public Health Facilities: Challenges and the Role of Automation Technologies

The impact of COVID-19 on routine child immunisation in South Africa

BackgroundThe COVID-19 pandemic disrupted immunisation programs worldwide, reversing gains that had brought vaccine-preventable diseases largely under control. This study explored the impact of COVID-19 on the uptake of routine child immunisation services in South Africa.MethodsWe conducted qualitative research using in-depth interviews with 51 purposively selected parents/caregivers of children below the age of five who missed or delayed one or more scheduled immunisation doses in 2020–2022 and with 12 healthcare providers who provided public immunisation services during the pandemic.ResultsDuring the pandemic lockdowns, most caregivers perceived the risk of their child being infected with COVID-19 during a clinic visit as more salient than the risk of missing immunisation doses. Caregivers reported minimal exposure to routine immunisation communication, as well as shortages of routine vaccines for children at public health facilities, healthcare workers experienced anxiety and burnout. There was a post-pandemic shift to more active decision-making about immunisation, which had previously been an almost automatic behaviour, leading some caregivers to delay vaccinating their children. There was also evidence of a “bad vaccine” mental model among some caregivers regarding COVID vaccinations, which could lead to doubts about the safety of routine childhood vaccinations.DiscussionThe shift from default to active decision-making highlights a risk that routine immunisation will backslide in future pandemics. Governments should build resilient health systems at all levels and communicate clearly about the benefits and availability of RIs and the safety of vaccinations in general, alongside supply-side interventions.ConclusionRoutine immunisation is widely accepted in South Africa, driven by generational norms and provider recommendations. During the COVID-19 pandemic, many caregivers faced the dilemma of balancing COVID-19 exposure risk with the risk of their child developing a deadly VPD, leading to missed RI visits. This shift to active decision-making highlights a future pandemic risk. Governments should build resilient health systems and focus on understanding and engaging procrastinating and doubtful caregivers. Clear communication about RI benefits and vaccine safety is crucial, as misinformation can lead to distrust in new vaccines.

Factors Associated with Complications of Snakebite Envenomation in Health Facilities in the Cascades Region of Burkina Faso from 2016 to 2021

Snakebite envenomation remains a major cause of morbidity and mortality in rural populations. This study identified factors associated with the complications of snakebite envenomation reported in the Cascades region of Burkina Faso. This cross-sectional study used the routine data of patients admitted for snakebite envenomation at five health facilities between 1 January 2016 and 31 December 2021. Data were collected on sociodemographic, clinical, and therapeutic characteristics of patients with signs of envenomation. Bivariate and multivariate analyses were conducted to identify factors associated with complications. Among the 846 patients with envenomation, 355 (42%) experienced complications. Local complications (23.2%, 196/846) included wounds and skin necrosis, whereas systemic complications (34.3%, 290/846) included hemorrhage, shock, and coma. Of all complicated cases, 7.6% (27/355) died. Factors associated with complications were rural residence (AOR: 4.80; 95% CI: 2.21–11.4), incision at the bite site (AOR: 4.31; 95% CI: 2.51–7.52), tourniquet application (AOR: 5.52; 95% CI: 1.42–30.8), bleeding (AOR: 14.2; 95% CI: 8.80–23.4), abnormal vital signs (AOR: 14.3; 95% CI: 9.22–22.7), and lack of antivenom administration (AOR: 2.92; 95% CI: 1.8–4.8). These findings highlight the importance of antivenom availability and public awareness for reducing the incidence of complications of snakebite envenomation.

Prevalence, Predictors and Reasons for Discharge Against Medical Advice Among Patients With Chronic Disease During COVID-19.

Discharge against medical advice (DAMA) is used in healthcare facilities in a situation where patients refuse care or decide to leave the hospital before the treating physician recommends discharge. Previous studies have found DAMA to be prevalent among patients with various chronic conditions. The study had four objectives. The study aimed to investigate: (1) the prevalence of DAMA during COVID-19 (2020-2021) among Jordanian patients with chronic diseases, (2) the association between DAMA and sociodemographic and clinical characteristics of patients with chronic diseases, (3) the predictors of DAMA and (4) the reasons behind DAMA at the patient, hospital and environmental levels. A descriptive cross-sectional correlational design was used in the study. A convenience sampling approach was used to collect data from 1576 patients with chronic diseases from 3 private hospitals. The study found that the prevalence rate of DAMA was 33.3%. There was a significant association between the sociodemographic and clinical characteristics of patients with chronic diseases and DAMA. Health insurance found to be the strongest predictor of DAMA. Finally, the study found that patient, hospital and environmental-related factors had a low impact on DAMA. DAMA is prevalent among patients with chronic diseases in Jordan during COVID-19 pandemic. The current study's findings can serve as an empirical basis for planning and implementing DAMA prevention programs and/or establishing or revising policies for the target population.

Index for Assessing the Performance Level of Vehicular Traffic on Urban Streets

Vehicular transportation is one of the most widely used modes in modern cities for reaching key destinations such as workplaces, healthcare facilities, recreational areas, and educational institutions, among others. However, the performance of vehicular traffic on these roads can vary significantly due to the influence of different environmental variables. In the literature, factors such as traffic incidents, weather conditions, road infrastructure, and driving habits, among others, have been identified as impacting vehicular traffic performance. In this context, predictive models have been developed to anticipate congestion at specific points in cities based on statistics, machine learning, simulation, and complex networks. This study proposes a novel index aimed at assessing the level of performance of vehicular traffic on streets based on the relationship among relevant urban environmental variables. This index is generated through Genetic Programming, considering a set of variables related to traffic, incidents, and services. The case study will focus on the streets of the Tlalpan Municipality in Mexico City.

Viêm tĩnh mạch tại vị trí lưu kim luồn tĩnh mạch ngoại biên và một số yếu tố liên quan tại Trung tâm Thần kinh, Bệnh viện Bạch Mai

Introduction: Peripheral venous catheter-related phlebitis is a common complication in healthcare facilities, causing pain, disrupting treatment, and potentially leading to severe complications.Objective: This study investigates the incidence and risk factors associated with peripheral intravenous catheter-related phlebitis. Method: A prospective cross-sectional descriptive study was conducted using a self-designed questionnaire and the Visual Infusion Phlebitis (VIP) Scale to assess the degree of phlebitis. The study included 347 inpatients treated in the Emergency and Intensive Care Unit, Neurology Center, at Bach Mai Hospital. Data were collected from medical records and clinical observation. Results: Among the studied patients, the incidence of phlebitis was 17.6%, and 4.3% of catheter insertion sites exhibited signs of inflammation. Grade 1 and 2 were the most common phlebitis (43.1% and 54.2%), with a small number of grade 3 cases (2.8%) and no cases of grade 4 or 5. Factors such as catheter insertion sites in the forearm, elbow, or ankle; underlying conditions like hypertension, cerebral hemorrhage, pneumonia; paralysis; continuous fluid infusion; and certain intravenous medications were identified as being associated with an increased risk of phlebitis. Conclusion: Phlebitis at the PVC site is a significant concern during treatment in ICU and Neurology centers. Proper catheter site selection and effective management of underlying conditions can help reduce the risk of phlebitis. These findings may assist in developing clinical guidelines to improve patient care quality.

Information seeking behaviour of informal caregivers at the premier tertiary teaching hospital in Nigeria

This study was conducted to examine the information behaviour of informal caregivers in a university college hospital in Ibadan, Nigeria. Informal caregivers in the teaching hospitals constitute critical pubic health care players whose information behaviours have not been studied. Data was collected from 208 caregivers using a questionnaire that consisted of structured and open-ended questions. The study found that healthcare providers were the primary source of health for caregivers, with 34.1% actively seeking information from them. The caregivers seldom utilised sources like the internet, community organizations, books, family, and friends. The preference for healthcare providers as sources is due to their accessibility and ability to provide prompt and accurate answers. Caregivers have diverse information needs, including medication-related information, first aid techniques, nutrition, exercise, mental health, and lifestyle choices. They seek this knowledge to make informed decisions that improve their loved ones’ well-being. The study also revealed that caregivers heavily rely on information technology for health information due to its accessibility and reliability. The study highlights the need for ongoing training and proactive information sharing by healthcare providers to better support informal caregivers in Nigeria, emphasizing the importance of integrated support systems within healthcare facilities. To meet diverse information needs, healthcare institutions should diversify dissemination strategies, including culturally sensitive materials and digital literacy programs, while developing tailored mobile applications and online support communities for caregivers. Policymakers must focus on creating supportive healthcare policies, funding caregiver programs, and expanding insurance coverage to alleviate financial burdens, ensuring that caregivers have access to necessary resources and information.

DETERMINATION OF DOSE REFERENCE LEVELS AT BENDAN PEKALONGAN REGIONAL HOSPITAL FOR INTERNAL DOSE AUDIT AS AN EFFORT TO OPTIMIZE RADIATION PROTECTION FOR PATIENTS

Unnecessary exposure is less of a concern because it is considered not to cause injury to patients. Radiation protection optimization is carried out for patients to reduce unnecessary exposure. Following BAPETEN Regulation No. 4 of 2020 Article 46, permit holders are required to implement radiation protection optimization [1]. This study aimed to obtain the local dose reference level (TPD) value through an internal dose audit to optimize patient radiation protection. This optimization is carried out in several steps, including conducting an internal dose audit, determining the local TPD, and evaluating the examination. This study is expected to motivate documentation of radiation parameters to obtain sufficient data for analysis. The method used in this study is a literature study through related references and X-ray radiation output data to calculate the dose in the form of incident air kerma (INAK) and entrance surface air kerma (ESAK). The results showed that the local INAK TPD value was 52% below the national TPD, and the local ESAK TPD value was 57% below the national TPD. The expected local TPD value is a TPD value that is lower than the national TPD value. This indicates that the imaging protocol at RSUD Bendan has been well-optimized. However, there are still several types of examinations where the local TPD value exceeds the national TPD, indicating the need to review further the imaging techniques and protocols used. The influence of body weight and radiological image diagnosis was analyzed as a basis for further optimization. Thus, the determination of this local TPD can be an essential reference in efforts to improve patient safety and optimize radiation protection in health facilities. Keywords: radiation protection optimization of patient, Dose Reference Level (DRL), patient dose.

Determinants of antiretroviral therapy adherence among people living with HIV in a poor urban setting in Ghana: a hospital-based cross-sectional study.

Without a cure, antiretroviral therapy (ART) continues to be the primary mode of managing HIV, transforming it from a formerly lethal disease to a less severe one. Adherence to ART can be impacted by several factors, including poor quality of care. A quantitative cross-sectional study design was used to assess the factors that influence adherence to ART among adults receiving care at two health facilities in Accra. A structured interviewer-administered questionnaire was used to collect data on factors associated with medication adherence using a modified four-item Medication Adherence Rating from 255 people living with HIV (PLHIV). Descriptive statistics were used to summarise the data, while multiple binary logistic regression was used to assess the factors influencing adherence to ART. Adherence to HIV medication was 44.7% among PLHIV. Adherence was positively correlated with high client health service satisfaction (adjusted OR [AOR]: 26.59, 95% CI 7.46 to 94.82, p<0.001), increased privacy at the HIV clinics (AOR: 3.40, 95% CI 1.40 to 8.21, p<0.007) and among PLHIV who had been diagnosed with HIV for ≥5 y (AOR: 7.59, 95% CI 2.76 to 20.85, p<0.001). Adherence to ART was significantly low among study participants. The study highlights the importance of maintaining privacy and confidentiality at the facility while ensuring client satisfaction with HIV care to promote adherence to ART.