“We Are Now Free to Speak”: Qualitative Evaluation of an Education and Empowerment Training for HIV Patients in Namibia

<div><p>Although numerous studies provide evidence that active patient engagement with health care providers improves critical outcomes such as medication adherence, very few of these have been done in low resource settings. In Namibia, patient education and empowerment trainings were conducted in four antiretroviral (ART) clinics to increase patient engagement during patient-provider interactions. This qualitative study supplements findings from a randomized controlled trial, by analyzing data from 10 in-depth patient interviews and 94 training evaluation forms. A blended approach of deductive and inductive coding was used to understand training impact. Findings indicated the trainings increased patients’ self-efficacy through a combination of improved HIV-related knowledge, greater communication skills and enhanced ability to overcome complex psychosocial barriers, such as fear of speaking up to providers. This study suggests patient empowerment training may be a powerful method to engage HIV patients in their own care and treatment.</p></div

Demographic Data of Interviewed Patients.

<p>Demographic Data of Interviewed Patients.</p

Location of Task Shifting Doctors and Nurses.

<p>*No paired observation possible between doctor and nurse at this hospital.</p

Task shifting demonstration project sites in Namibia.

<p>Task shifting demonstration project sites in Namibia.</p

Agreement Found During Clinical Observations (95% CI).

<p>Agreement Found During Clinical Observations (95% CI).</p

Task Shifting Sites: Number of Patients on ART as of December 31, 2010^*.

<p>*Data source: Namibia National Data Base (NDB).</p

Early Warning Indicator Trend Analysis Comparing Main and Outreach Site Performance.

<p>Early Warning Indicator Trend Analysis Comparing Main and Outreach Site Performance.</p

Selected 2014 WHO Early Warning Indicator Definitions (Numerator/Denominator) and Targets.

<p>Selected 2014 WHO Early Warning Indicator Definitions (Numerator/Denominator) and Targets.</p

Early Warning Indicator Trend Analysis Comparing 2012 and 2014 Main Site Performances.

<p>Early Warning Indicator Trend Analysis Comparing 2012 and 2014 Main Site Performances.</p

Pediatric Site-specific EWI Results.

<p>EWI—Early Warning Indicators Green indicates sites that achieved excellent performance, desired target level. Yellow indicates sites that achieved fair performance, progressing towards desired target level. Red indicates poor performance, below desired target. Gray indicates that data was not available from that site.</p