Level of Healthcare Providers’ Preconception Care (PCC) Practice and Factors Associated with Non-Implementation of PCC in Hawassa, Ethiopia

BACKGROUND: Healthcare providers (HCPs) are at the forefront of screening and identifying preconception risk factors leading to adverse pregnancy outcomes (APOs). In Ethiopia, there is no published study that assessed the status of the implementation of PCC. This is a study conducted with the aim of determining the level of HCP’s PCC practice and factors associated with non-implementation of PCC.METHODS: This institution based cross-sectional study conducted among HCPs working in public health institutions (PHI) of Hawassa. The data was collected using a validated instrument called ‘Andarg-Ethio PCC-KAPQuestionnaire’. A ltistage sampling was applied to draw a sample of 634 HCPs. The data were analyzed using SPSS software, version 20. Descriptive statistics and binary as well as multiple logistic regression analysis models were used to determine the cruds and adjusted odds ratios.RESULTS: Out of the total study participants, 84.7%(537) were found not totally practising PCC. Those HCPs who do not screen their clients’ reproductive life plan (RPL) had 7 times higher odds of not practising PCC (AOR=7.2 95% C.I. 3.6- 14.5), whereas those HCPs with poor PCC knowledge had 4 times higher odds of not practising PCC (AOR= 4.4, 95% C.I. 2.5-7.6).CONCLUSION: The findings of this study demonstrated the absence of standardized and consistent PCC practice which indicates that PCC is not well introduced to the area. Developing of PCC policy and guidelines plus training of HCPs are recommended.

Exploring the contribution of general self-efficacy to the use of self-care symptom management strategies by people living with HIV infection

General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n = 569) of an international 12 site longitudinal randomized controlled trial (RCT) (n = 775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Symptom burden, engagement with the provider, and antiretroviral adherence were analyzed with regard to GSE. Our data indicated that there were differences in the perceived symptom burden over time of HIV infected individuals by GSE. Those individuals with higher GSE had fewer symptoms and these symptoms were perceived to be less intense than those experienced by the low GSE group. There were few meaningful differences in the SCSMS used by those with high versus low GSE other than the use of illicit substances in the low GSE group. The low GSE group was also significantly ( p= \u3c 0.001) less engaged with their healthcare providers. Given the difference in substance use by perceived GSE, and the importance of engagement with the healthcare provider, more attention to the resolution of the concerns of those with low GSE by healthcare providers is warranted

Engagement with Care, Substance Use, and Adherence to Therapy in HIV/AIDS

Engagement with care for those living with HIV is aimed at establishing a strong relationship between patients and their health care provider and is often associated with greater adherence to therapy and treatment (Flickinger, Saha, Moore, and Beach, 2013). Substance use behaviors are linked with lower rates of engagement with care and medication adherence (Horvath, Carrico, Simoni, Boyer, Amico, and Petroli, 2013). This study is a secondary data analysis using a cross-sectional design from a larger randomized controlled trial (n = 775) that investigated the efficacy of a self-care symptom management manual for participants living with HIV. Participants were recruited from countries of Africa and the US. This study provides evidence that substance use is linked with lower self-reported engagement with care and adherence to therapy. Data on substance use and engagement are presented. Clinical implications of the study address the importance of utilizing health care system and policy factors to improve engagement with care

Does “Asymptomatic” Mean Without Symptoms for Those Living with HIV Infection?

Throughout the history of the HIV epidemic, HIV-positive patients with relatively high CD4 counts and no clinical features of opportunistic infections have been classified as ‘‘asymptomatic’’ by definition and treatment guidelines. This classification, however, does not take into consideration the array of symptoms that an HIV-positive person can experience long before progressing to AIDS. This short report describes two international multi-site studies conducted in 2003 - 2005 and 2005 - 2007. The results from the studies show that HIV-positive people may experience symptoms throughout the trajectory of their disease, regardless of CD4 count or classification. Providers should discuss symptoms and symptom management with their clients at all stages of the disease

Engagement with Care, Substance Use, and Adherence to Therapy in HIV/AIDS

Engagement with care for those living with HIV is aimed at establishing a strong relationship between patients and their health care provider and is often associated with greater adherence to therapy and treatment (Flickinger, Saha, Moore, and Beach, 2013). Substance use behaviors are linked with lower rates of engagement with care and medication adherence (Horvath, Carrico, Simoni, Boyer, Amico, and Petroli, 2013). This study is a secondary data analysis using a cross-sectional design from a larger randomized controlled trial (n=775) that investigated the efficacy of a self-care symptom management manual for participants living with HIV. Participants were recruited from countries of Africa and the US. This study provides evidence that substance use is linked with lower self-reported engagement with care and adherence to therapy. Data on substance use and engagement are presented. Clinical implications of the study address the importance of utilizing health care system and policy factors to improve engagement with care

Administrative and managerial patterns on the RtHC in the Makhado municipality rural clinics

This paper investigates the administrative and managerial pattern on the Road to Health Chart (RtHC) among clinics in the Makhado municipality. Retrospective observations of the processes of recordings the nurses performed on the RtHC (?=36) were carried out to collect data. A checklist was used to aid the observations. Furthermore, face-to-face interviews were administered on participant nurses in collaboration with document review. The results of this paper revealed considerable omissions on the administration and management of the RtHC instrument. Crucial information was also incorrectly recorded while some was never recorded at all. Clinic managers should continuously monitor the nurses on the administration and management of the RtHC to ensure quality

Resource challenges experienced by HIV-positive women on the PMTCT programme at a hospital in Bulawayo, Zimbabwe

The aim of the study was to gain an understanding of the lived experiences of HIV-positive women who utilised the prevention of mother-to-child transmission (PMTCT) services at a central hospital in Zimbabwe. The PMTCT programme plays an integral role in the management of HIV transmission. The effective implementation of the PMTCT programme cannot be overemphasised. This study utilised a qualitative, descriptive, phenomenological research design. Data was gathered using in-depth individual interviews that were audio recorded. Fifteen HIV-positive PMTCT clients participated in the study. Data was analysed using interpretive phenomenological analysis. The results showed that the clients attending the PMTCT programme experienced several challenges as they utilised the services, emanating from material, financial and human resource-related challenges. The implication for effective implementation of the PMTCT programme is that there should be adequate resource provision.College of Human Science

Resource Challenges Experienced by Hiv-Positive Women on the Prevention of Mother to Child Transmision Programme at A Hospital in Bulawayo, Zimbabwe

The aim of the study was to gain an understanding of the lived experiences of HIV-positive women who utilised the prevention of mother-to-child transmission (PMTCT) services at a central hospital in Zimbabwe. The PMTCT programme plays an integral role in the management of HIV transmission. The effective implementation of the PMTCT programme cannot be overemphasised. This study utilised a qualitative, descriptive, phenomenological research design. Data was gathered using in-depth individual interviews that were audio recorded. Fifteen HIV-positive PMTCT clients participated in the study. Data was analysed using interpretive phenomenological analysis. The results showed that the clients attending the PMTCT programme experienced several challenges as they utilised the services, emanating from material, financial and human resource related challenges. The implication for effective implementation of the PMTCT programme is that there should be adequate resource provision

The Impact of Stressful Life Events, Symptom Status, and Adherence Concerns on Quality of Life in People Living With HIV

Studies concerning persons living with HIV (PLWH) report that stressful life events (SLEs) contribute to an exacerbation of symptoms and reduced antiretroviral (ARV) adherence and quality of life (QOL). Little is known about whether these findings are site-specific. Our study's aims were to characterize the type and frequency of SLEs for PLWH in Puerto Rico, South Africa, and the United States, and to assess the impact of SLEs by national site, symptoms, and ARV adherence concerns on QOL. The sample consisted of 704 participants. The total number of SLEs correlated significantly with the total number of symptoms, adherence concerns, and QOL (p ≤ .001). Overall, 27.2% of the variance in QOL was explained by the aforementioned variables. Although SLEs were of concern to PLWH, worries about ARV adherence were of even greater concern. Routine assessment of ARV concerns and SLEs can promote ongoing ARV adherence and improved QOL