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A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research

Overview of attention for article published in BMC Public Health, February 2016
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Title
A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research
Published in
BMC Public Health, February 2016
DOI 10.1186/s12889-016-2830-6
Pubmed ID
Authors

Bereket Yakob, Busisiwe Purity Ncama

Abstract

Access to healthcare is an essential element of health development and a fundamental human right. While access to and acceptability of healthcare are complex concepts that interact with different socio-ecological factors (individual, community, institutional and policy), it is not known how these factors affect HIV care. This study investigated the impact of socio-ecological factors on access to and acceptability of HIV/AIDS treatment and care services (HATCS) in Wolaita Zone of Ethiopia. Qualitative case study research was conducted in six woredas (districts). Focus group discussions (FGDs) were conducted with 68 participants in 11 groups (six with people using antiretroviral therapy (ART) and five with general community members). Key informant interviews (KIIs) were conducted with 28 people involved in HIV care, support services and health administration at different levels. Individual in-depth interviews (IDIs) were conducted with eight traditional healers and seven defaulters from (ART). NVIVO 10 was used to assist qualitative content data analysis. A total of 111 people participated in the study, of which 51 (45.9 %) were male and 60 (54.1 %) were female, while 58 (53.3 %) and 53 (47.7 %) were urban and rural residents, respectively. The factors that affect access to and acceptability of HATCS were categorized in four socio-ecological units of analysis: client-based factors (awareness, experiences, expectations, income, employment, family, HIV disclosure and food availability); community-based factors (care and support, stigma and discrimination and traditional healing); health facility-based factors (interactions with care providers, availability of care, quality of care, distance, affordability, logistics availability, follow up and service administration); and policy and standards (healthcare financing, service standards, implementation manuals and policy documents). A socio-ecological perspective provides a useful framework to investigate the interplay among multilevel and interactive factors that impact on access to and acceptability of HATCS such as clients, community, institution and policy. Planners, resource allocators and implementers could consider these factors during planning, implementation and evaluation of HATCS. Further study is required to confirm the findings.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 245 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Belgium 1 <1%
Unknown 244 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 44 18%
Researcher 32 13%
Student > Ph. D. Student 27 11%
Student > Bachelor 25 10%
Student > Doctoral Student 11 4%
Other 36 15%
Unknown 70 29%
Readers by discipline Count As %
Nursing and Health Professions 50 20%
Medicine and Dentistry 42 17%
Social Sciences 33 13%
Psychology 9 4%
Agricultural and Biological Sciences 7 3%
Other 23 9%
Unknown 81 33%