ABSTRACT
"Background: Community health centres (CHCs) are an important component of the health system in Mali and China. Despite patient support and commitment from the authorities; the management and the quality of care of these structures need to be improved. This research aimed to compare the management style of the relevant boards with users' satisfaction pertaining to CHC services in Mali and China. Method: Between September 2009-January 2010; a study was conducted in eight CHCs in Mali and in 16 CHCs in China. A total of 480 householders; [60 (Mali) and 320 (China)]; and 24 management committee members (Mali) and 48 management committee members (China) were interviewed. An in-depth interview technique was used on members of the management committee; while a structured interview was carried out to ollect data during face-to-face contact with householders in their residences. In residences in which there were two or more households; the first willing householder was interviewed. Questions about the level of satisfaction were coded from 1-5 and ranged from ""excellent"" to ""very bad"" respectively. Results: The CHCs in China were managed by the government; whereas in Mali; they were overseen by the local population. The most satisfied people in both countries were those living in the poorest socioeconomic conditions; the elderly; and those who attended the healthcare meetings. Chinese households were more satisfied with the quality of the CHC services than those in Mali. The Chinese management boards proposed standardisation of rules and more funding; whereas those in Mali advocated that government provide more funding and human resources allocation. Conclusion: A high level of satisfaction regarding the CHC services was observed. However; users reported on deficits in the quality of care; whereas management suggested a need for greater resource allocation."
Subject(s)
Delivery of Health Care , Health Care Evaluation Mechanisms , Health Care Reform , Organization and Administration , Primary Health Care , Quality of Health CareABSTRACT
Background: Stigma and discrimination can limit access to care and treatment services. Stigma hides HIV from the public; resulting in reduced pressure for behavioral change. For effective behavior change; empirically grounded and theory-based behavioral change approaches are fundamental as a prevention interventions directed on decreasing stigma and discrimination. The objective of the study was to assess the experience of stigma and discrimination on the psychosocial and health care seeking behavior of people living with HIV/AIDS (PLHIV) in Arba Minch; Ethiopia. Methods: This study uses qualitative methods involving focus-group discussions and in-depth interviews conducted in Arba Minch town and nearby Kebeles. Our sample consisted of PLHIV and other key informants who were purposively selected. Data were analyzed manually using thematic content analysis framework. Results: It appears that the magnitude of stigma and discrimination in the area has decreased to a considerably lower level; however; the problem's severity is still being influenced by various factors including: current residence; disclosure status and level of community's awareness about HIV/AIDS. Care and support services provided to PLHIV were well accepted by the respondents and the majority of them were willing to make use of any service available. Health information messages that have been disseminated to the public through mass media since the start of the epidemic in 1984 and AIDS cases in 1986 have played a significant role regarding the current prevailing problem of stigma and discrimination of PLHIV. Conclusion: Stigma and discrimination have come to a level that can be tolerated by most PLHIV that live in this region; especially those who have disclosed their HIV status and were living in urban areas. This calls for a strategy that improves the rates of serostatus disclosure after HIV counseling and testing and strengthens and integrates activities in the task of expanding care and support activities