https://orcid.org/0000-0002-5596-8401
Abstract
Background
Globally, an estimated 1.7 million new human immunodeficiency virus (HIV) infections occurred in 2018. Although significant progress has been made still, it remained a public health threat. Thus, this capstone project aimed to improve the quality of services among anti-retroviral therapy (ART) users through a strategic problem-solving approach at Bure Primary Hospital, northwest Ethiopia, 2020.
Methods
A before–after study design was employed among 357 people living with HIV (PLWH) clients on ART from December 2019 to January 2020 and from April to May 2020 pre and post capstone project. The capstone project involved regular internal mentorship, availing supplies, and providing refresher training. Data were entered using EPI data version 3.1 and exported to SPSS version 23 statistical for analysis. Paired t-test was used for comparing the mean scores before and after the capstone project. A mean score with 95% CI and a P-value <0.05 were used to determine the effect of the capstone project on the quality of the service.
Results
The overall quality of ART service was improved as evidenced by the presence of a positive gap score (+0.0164) according to the SERVQAUL model. Receiving first CD4 count was improved from 65% to 85.1% and screening for TB from 90% to 97% with 95% CI at a p-value of 0.001. Whereas, viral load measurement at six months is 78% to 89.75% and IPT uptake is 62% to 71% with 95% CI at a p-value of 0.013 and 0.004, respectively.
Conclusion
Ensuring regular internal mentorship, availing supplies, and providing refresher training have a significant effect on the quality of ART service. Therefore, adhering to national guidelines and fulfilling the availability of the recommended infrastructures helps to improve the quality of ART service.
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Data Sharing Statement
All the data were included in the study, and data will be available upon a reasonable request from the corresponding author.
Ethics Approval and Consent to Participate
Ethical approval was obtained from the Ethical Committee of the Institute of Public Health, College of Medicine and Health Sciences, the University of Gondar (Ref. No. IPH/837/2020). Before the actual data collection was started, an official permission letter was obtained from Bure Primary Hospital. After a brief description of the study’s purpose, risk, and benefits, written consent was obtained from participants, and for <18 years, parental informed consent was obtained. Data were anonymous and held on a secure password-protected system. Confidentiality during all phases of research activities was kept. This study was conducted in accordance with the Declaration of Helsinki.
Acknowledgments
Our gratitude goes to the University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Health Systems and Policy to conduct this capstone project on the selected topic. Furthermore, our in-depth gratitude goes to data collectors and supervisors who helped us a lot and study participants for their valuable time spent in the interview. Finally, we would like to express our in-depth gratitude to Bure Primary Hospital senior management team for their support on any occasion.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests in this work.