of the quality of care: a study among Caribbean persons living with HIV in
Barbados, Jamaica and Haiti
S. Trim, B. Bain, S. Martin
Caribbean HIV/AIDS Regional Training Network (UWI), Office of the Vice Chancellor, Kingston, Jamaica
Background: A qualitative study was conducted in Jamaica, Barbados and Haiti among persons living with HIV (PLHIVs) to document their perceived quality of healthcare delivered by thier health service providers. The objectives were to: 1) determine the factors affecting PLHIVs' perceptions of the quality of health care they receive, and 2) document their experiences of interactions with particular groups of health service providers.
Methods: Focus groups and in-depth interviews were conducted with 67 participants in the 3 countries. A structured survey was also used to capture information on primary treatment facilities and interaction with health care providers. Qualitative and quantitative data analyses were done.
Results: The mean age of study participants' was 36 years. The majority of informants were female (64%) and have been living with HIV between 4-9 years. Nearly all reported positive interactions with health care providers. Most notable were: discussion of the pros and cons of treatment (84%) and the explanation of the use of HIV medications (81%) (Haitian informants were the exception in the latter category). Points of dissatisfaction related to confidentiality among auxiliary workers, waiting time, need for holistic treatment and stigma and discrimination. Forty-nine percent of respondents rated their overall quality of care as 'good/very good' and 37% as 'excellent'. A large majority in all three study countries expressed the view that their health care provider would provide “the best care they can give to their patient.”
Conclusions: PLHIV were positive in their overall rating of care received, especially in interactions with their direct care provider. However, it appears that other areas of service delivery need to be strengthened, especially improving confidentiality amongst auxiliary workers, reduction of stigma and discrimination experienced in the health centre and improved psychosocial support (holistic care) of PLHIVs.
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