Investigating client satisfaction with antiretroviral treatment services in South-South Nigeria

Client satisfaction is a key method of evaluating the quality of healthcare services. This research investigated client satisfaction with anti-retroviral treatment services in selected outpatient facilities in Rivers State. This study was a qualitative study carried out in four antiretroviral treatment (ART) facilities in Rivers State, Nigeria. Researchers conducted nine Key Informant Interviews (KIIs), 25 In-depth interviews (IDIs) and eight Focus Group Discussion (FGDs) among 73 Persons Living with HIVs (PLHIVS) consisting of 31 males and 42 females, using a topic guide. Interviews were recorded, transcribed and analysed using thematic content analysis. Majority of study participants interviewed reported being very satisfied with confidentiality, health worker attitude, interpersonal communication, counselling, and availability of drugs. The major sources of dissatisfaction included overcrowding, long waiting time and inadequate/expensive laboratory services. Suggestions proffered for improving the quality of care at the centres included increasing staff strength at the treatment centres, improving the quality and cost of laboratory services, and infrastructure upgrade. This study demonstrates the role health workers and facility processes play in satisfaction with services at HIV treatment centres. Health workers, programme officers, and managers in HIV prevention, care and treatment need to pay attention to these issues if they would be successful in improving the quality of care for PLHIVs

Determinants of Modern Contraceptive Uptake among Women in Peri-Urban Communities of Port Harcourt City, Nigeria.

Aim: The aim of the study was to investigate the determinants of contraceptive uptake among women of reproductive age in semi-urban communities of Rivers State, Nigeria. The information will be useful in reordering priorities and strategies for family planning interventions in the state. Study Design: The study was a cross sectional, household-based study, employing a cluster sampling technique proportionate to size, to recruit eligible participants. Study Location: The study was carried out in September 2013 in five contiguous communities located at the fringes of the Port Harcourt city. Methodology: Anonymous questionnaires were administered to 772 women of reproductive age normally resident in these five communities. Visitors were excluded. The data was analysed using SPSS version 20 software package. The Chi-square test was performed to determine the association between contraceptive use and demographic and socioeconomic variables, while Logistic regression was used to identify determinants of contraceptive uptake. The level of statistical significance was set at p= .05. Results: A total of 772 women aged (15-49) years participated in the study and 731 (94.7%) knew about modern contraceptives and their benefits. Young age (15-34 years old), (χ2= 12.7, df = 3, p= .01) and being single, (χ2=16.270, df=3, p < .01) were significantly associated with contraceptive usage. Younger women had six times higher odds of contraceptive usage than older women; [O.R (95% C. I) = 5.97 (1.56-22.90) and 5.96 (1.63 -21.71)], and women with contraceptive knowledge had 19% higher odds of usage than contraceptive naïve women [O.R (95% C. I) = 0.19 (0.09-0.40)]. Conclusion: This study underscores the importance of young age and knowledge about contraceptives in promoting its acceptance among women. We therefore advocate for an early introduction of curriculum-based family planning education in schools, local media campaigns and peer education to create more awareness about contraceptives.

Attitude of Residents of a Rural Community in South-South, Nigeria towards Alternative Medical Therapy.

Background: Up to 80 percent of Africans are reported to use some form of alternative medical therapy (AMT) to meet their health needs. There are gaps in knowledge relating to attitude towards AMT in south- south Nigeria. An understanding of beliefs and the prevailing factors that influence the patronage of traditional medicine in this environment may help inform policy interventions. Objectives: This study aimed to assess the awareness of and attitude towards AMT amongst the inhabitants of a rural community in south-south Nigeria. Materials and Methods: This was a cross sectional survey involving 300 respondents selected by a two stage sampling technique, using a self-designed interviewer administered structured questionnaire. Results were presented as proportions with chi-squared test done to determine associations. Level of significance was set at 0.05. Results: Mean age of the 300 respondents was 35.7±11.7 with 237 persons (79.0%) earning less than $250 monthly and 168 (56.0%) having secondary education. Majority 297 (99%) were aware of AMT and 287 (95.7%) cited herbal concoctions as the most prevalent method. Few were aware of side effects of AMT 71 (23.7%). Majority 208 (69.3%) preferred AMT to orthodox treatment, and were willing to refer others to AMT practitioners. Of these 159 (76.4%) claimed AMT to be more effective and 140 (67.3%) more affordable. Age of respondents, educational status, occupation and average monthly income were all found to be associated with preference of AMT (p<0.5). Conclusion: Alternative medical therapy is favoured by majority of the respondents in spite of the risks. Public enlightenment campaigns, better regulation, and implementation of community health insurance for affordable health care are advocated.

Caregiver Experiences with the Introduction of Pentavalent Vaccines in Two Centers in Port Harcourt, South-South Nigeria.

Background: The Nigerian government, with support from the Global Alliance for Vaccine Initiative (GAVI) in 2012, began a three year phased roll out of the pentavalent vaccine as a replacement for DPT in the routine immunization schedule. Aim: To assess client experiences with the use of pentavalent vaccines in two centers in Port Harcourt, Nigeria. Methods: A cross-sectional study was carried out in January 2013. Caregiver-baby pairs who had index child six weeks to two years, who had received at least one dose of the pentavalent vaccine and had at least one other living child who took DPT, were interviewed using a semi-structured questionnaire. Chi squared test of significance was done with p-value set at 0.05. Results: One hundred and eleven (111) caregivers were interviewed. Their mean age was 31±4.6 years, while mean age for babies was 16±8.6 weeks. Although 71 caregivers (76.3%) had received pentavalent vaccine information only 25 (22.5%) had seen pentavalent-specific Information Education and Communication (IEC) materials. Majority of caregivers 94 (84.7%) affirmed that they did not have to pay for vaccination. Fifty-three (53) caregivers (47.7%) preferred pentavalent vaccines to DPT while 35 (31.55%) were indifferent. Eighty-one (81) (73%) caregivers were satisfied with waiting times for vaccination and 62 (57.4%) experienced adverse events following immunization (AEFI) with pentavalent vaccination. Conclusion: Pentavalent vaccines seem to have been well received in these centers with experiences of AEFI comparable to that of DPT. There is however need for appropriate vaccinespecific IEC materials to foster optimal uptake of pentavalent vaccines.