Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan-Dec:18:2325958218823285.
doi: 10.1177/2325958218823285.

Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya

Affiliations

Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya

Becky Genberg et al. J Int Assoc Provid AIDS Care. 2019 Jan-Dec.

Abstract

The burden on health systems due to increased volume of patients with HIV continues to rapidly increase. The goal of this study was to examine the experiences of HIV care providers in a high patient volume HIV treatment and care program in eastern Africa. Sixty care providers within the Academic Model Providing Access to Healthcare program in western Kenya were recruited into this qualitative study. We conducted in-depth interviews focused on providers' perspectives on health system factors that impact patient engagement in HIV care. Results from thematic analysis demonstrated that providers perceive a work environment that constrained their ability to deliver high-quality HIV care and encouraged negative patient-provider relationships. Providers described their roles as high strain, low control, and low support. Health system strengthening must include efforts to improve the working environment and easing burden of care providers tasked with delivering antiretroviral therapy to increasing numbers of patients in resource-constrained settings.

Keywords: HIV care; health providers; health systems; qualitative research; sub-Saharan Africa.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Location of 3 recruitment locations within the Academic Model Providing Access to Healthcare (AMPATH) program in western Kenya.

References

    1. Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800. doi:10.1093/cid/ciq243. - PMC - PubMed
    1. Ulett KB, Willig JH, Lin HY, et al. The Therapeutic implications of timely linkage and early retention in HIV Care. AIDS Patient Care STDS. 2009;23(1):41–49. doi:10.1089/apc.2008.0132. - PMC - PubMed
    1. Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antretroviral therapy care: a systematic review. AIDS. 2012;26(2):2059–2067. doi:10.1097/QAD.0b013e3283578b9b. - PubMed
    1. Geng EH, Nash D, Kambugu A, et al. Retention in care among HIV-infected patients in resource- limited settings: emerging insights and new directions. Curr HIV/AIDS Rep. 2010;7(4):234–244. doi:10.1007/s11904-010-0061-5.Retention. - PMC - PubMed
    1. Wachira J, Naanyu V, Genberg B, et al. Health facility barriers to HIV linkage and retention in Western Kenya. BMC Health Serv Res. 2014;14(1):646 doi:10.1186/s12913-014-0646-6. - PMC - PubMed

Publication types