Quality of Care at ART Clinic in Shashamanne Referral Hospital, West Arsi Zone, Oromia National Regional State, South Ethiopia

Abstract

Background: In low income nations like Ethiopia, which are heavily affected by HIV pandemic, health system needs to provide comprehensive services for escalating numbers of HIV positive patients. As demand increases, resources are not expanding at desirable rates to meet it. This leads to the risk of running poor quality antiretroviral therapy in resource limited health facilities but there is paucity of research based evidences on the quality of health services in the country in general, and on anti retroviral therapy in particular. Objective: To assess quality of care at antiretroviral therapy clinic in Shashamanne Referral Hospital. Methods: A cross-sectional study was conducted in Shashamanne Referral hospital from Sept. 20 to Oct.30, 2013. The study populations were selected people living with HIV, antiretroviral therapy clinics, and health care workers in antiretroviral therapy clinics during the study period. Stratified sampling method was used to select study population. Interviewer administered questionnaires were used for 204 patients to assess their satisfaction.Medical records review checklist was designed to get vital information from documents of 354 patients.Interview guide was also used to assess providers’ view on services. Data were entered using SPSS version 20 to maintain its quality and analyzed by descriptive, bivariate and multivariate techniques. Ethical clearance was obtained from Jimma University College of Public Health and Medical Sciences. Results: Resources required for implementation of antiretroviral therapy were available as per recommendation by the national Guideline but scarcity of some opportunistic infections drugs, anti retroviral drugs and absence of a few laboratory services seen in the hospital. HIV/AIDS care given in line with national guidelines, but this study revealed that only 42.7% of clients among eligible for isoniazid preventive therapy actually taken it. Seventy seven percent of clients were strongly dissatisfied on total length of stay at ART clinic and 72.5% of clients were dissatisfied on understanding results of laboratory tests like CD4 count meant for their health. Conclusion: Though services in ART clinic provided in line with the national guideline, desired coverage of isoniazid preventive therapy was not attained. Increased waiting time at medical record department and poor information provided to clients on their laboratory results were among main reasons for dissatisfaction at ART clinic. So collaborative efforts have to be exerted by Shashamanne referral hospital and other concerned bodies to optimize isoniazid prophylaxis, reduce increased waiting time and deliver adequate information for clients on results of their laboratory investigations at ART clinic