Top

BMC Health Services Research

Published in:

Open Access 01-12-2018 | Research article

Patients’ perspectives of acceptability of ART, TB and maternal health services in a subdistrict of Johannesburg, South Africa

Authors: Blaise Joy Bucyibaruta, John Eyles, Bronwyn Harris, Gaëtan Kabera, Kafayat Oboirien, Benon Ngyende

Published in: BMC Health Services Research | Issue 1/2018

Abstract

Background

The field of acceptability of health services is emerging and growing in coherence. But there are gaps, including relatively little integration of elements of acceptability. This study attempted to analyse collectively three elements of acceptability namely: patient-provider, patient-service organisation and patient-community interactions.

Methods

Mixed methods were used to analyse secondary data collected as part of the Researching Equity in Access to Health Care (REACH) study of access to tuberculosis (TB) treatment, antiretroviral therapy (ART) and maternal health (MH) services in South Africa’s public health sector.

Results

Provider acceptability was consistently high across all the three tracer services at 97.6% (ART), 96.6% (TB) and 96.4% (MH). Service acceptability was high only for TB tracer (70.1%). Community acceptability was high for both TB (83.6%) and MH (96.8%) tracers.

Conclusion

Through mixed methods, this paper provides a nuanced view of acceptability of health services.

Azia IN, Mukumbang FC, van Wyk B. Barriers to adherence to antiretroviral treatment in a regional hospital in Vredenburg, Western cape, South Africa. South Afr J HIV Med. 2016. https://doi.org/10.4102/sajhivmed.v17i1.476.

WHO. Tuberculosis: Global Tuberculosis Report 2017. 2017. http://www.who.int/tb/publications/factsheet_global.pdf?ua=1. Accessed 6 Aug 2018.

Adeniyi OV, Ajayi AI, Goon DT, Owolabi EO, Eboh A, Lambert J. Factors affecting adherence to antiretroviral therapy among pregnant women in the eastern cape. South Africa BMC Infect Dis. 2018. https://doi.org/10.1186/s12879-018-3087-8.

WHO. Fact Sheets: Maternal Mortality. http://www.who.int/news-room/fact-sheets/detail/maternal-mortality. 2018. Accessed 6 Aug 2018.

WHO. Fact Sheets: HIV/AIDS. 2018. http://www.who.int/news-room/fact-sheets/detail/hiv-aids. Accessed 6 Aug 2018.

WHO. Fact Sheets: Tubersulosis. 2018. http://www.who.int/news-room/fact-sheets/detail/tuberculosis. Accessed 6 Aug 2018.

SANAC. Let Our Actions Count: South Africa’s National Strategic Plan Plan for HIV, TB and STIs 2017–2022. 2017. http://sanac.org.za/wp-content/uploads/2017/05/NSP_FullDocument_FINAL.pdf. Accessed 6 Aug 2018.

Massyn N, Day C, Dombo M, Barron P, English R, Padarath A. District health barometer 2012/13. 2013. http://www.health-e.org.za/wp-content/uploads/2013/10/Web-DHB-2012-13.pdf. Accessed 6 Aug 2018.

Statistics South Africa. Millennium Development Goals 5: Improve maternal health 2015. 2015. http://www.statssa.gov.za/MDG/MDG_Goal5_report_2015_.pdf. Accessed 25 Aug 2017.

10.

Udjo EO, Lalthapersad-Pillay P. Estimating maternal mortality and causes in South Africa: national and provincial levels. Midwifery. 2014. https://doi.org/10.1016/j.midw.2013.05.011.CrossRef

11.

South Africa National Department of Health. National Health Insurance White Paper. 2017. http://pmg-assets.s3-website-eu-west-1.amazonaws.com/2/170630healthinsurancepolicydoc.pdf. Accessed 6 Aug 2018.

12.

Dookie S, Singh S. Primary health services at district level in South Africa: a critique of the primary health care approach. BMC Fam Pract. 2012; doi: https://doi.org/10.1186/1471-2296-13-67.

13.

Goddard M, Smith P. Equity of access to health care services: theory and evidence from the UK. Soc Sci Med. 2001. doi: https://doi.org/10.1016/S0277-9536(00)00415-9.CrossRef

14.

Thiede M, Akweongo P, McIntyre D. Exploring the dimensions of access. In: McIntyre D, Mooney G, editors. The economics of health equity. Cambridge: University Press; 2007. p. 103–23.CrossRef

15.

Penchansky R, Thomas WJ. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.CrossRef

16.

Gulliford M, Figueroa-Munoz J, Morgan M, Hughes D, Gibson B, Beech R, et al. What does ‘access to health care’ mean? J Health Serv Res Policy. 2002. https://doi.org/10.1258/135581902760082517.CrossRef

17.

Harris MF, Harris E, Roland M. Access to primary health care: three challenges to equity. Aust J Prim Health. 2004. https://doi.org/10.1071/PY04043.CrossRef

18.

Dillip A, Alba S, Mshana C, Hetzel MW, Lengeler C, Mayumana I, et al. Acceptability--a neglected dimension of access to health care: findings from a study on childhood convulsions in rural Tanzania. BMC Health Serv Res. 2012. https://doi.org/10.1186/1472-6963-12-113.

19.

Sekhon M, Francis, JJ, Cartwright M. et al. Acceptability of health care interventions: A theoretical framework and proposed research agenda. Br J Health Psychol. 2018. doi: https://doi.org/10.1186/s12913-017-2031-8.

20.

Silal SP, Penn-Kekana L, Harris B, Birch S, McIntyre D. Exploring inequalities in access to and use of maternal health services in South Africa. BMC Health Serv Res. 2012. https://doi.org/10.1186/1472-6963-12-120.

21.

Moshabela M, Schneider H, Silal SP, Cleary SM. Factors associated with patterns of plural healthcare utilization among patients taking antiretroviral therapy in rural and urban South Africa: a cross-sectional study. BMC Health Serv Res. 2012. https://doi.org/10.1186/1472-6963-12-182.

22.

Harris B, Eyles J, Penn-Kekana L, Thomas L, Goudge J. Adverse or acceptable: negotiating access to a post-apartheid health care contract. Glob Health. 2014. https://doi.org/10.1186/1744-8603-10-35.CrossRef

23.

Gilson L. Acceptability, Trust and Equity. In Mooney GM, editor. Cambridge: Cambridge University Press; 2007.

24.

McIntyre D, Thiede M, Birch S. Access as a policy-relevant concept in low- and middle-income countries. Health Econ Policy Law. 2009. https://doi.org/10.1017/S1744133109004836.CrossRef

25.

Bucyibaruta JB. Analysis of acceptability of HIV, TB, and maternal health services: a case study of a Johannesburg sub-district, South Africa. 2016. http://wiredspace.wits.ac.za/jspui/bitstream/10539/22202/1/November%2025%20submission.pdf. Accessed 25 Aug 2017.

26.

Chibango C. South Africa’s HIV and AIDS Policy and Legislation: An Analysis. Greener J Med Sci. 2013. doi: https://doi.org/10.15580/GJMS.2013.6.052413638.CrossRef

27.

South Africa National Department of Health. Implementation of the Universal Test and Treat Strategy for HIV Positive Patients and Differentiated Care for Stable Patients. 2016. http://www.sahivsoc.org/Files/22%208%2016%20Circular%20UTT%20%20%20Decongestion%20CCMT%20Directorate.pdf. Accessed 7 Aug 2018.

28.

Malterud K. Theory and interpretation in qualitative studies from general practice: why and how? Scand J Public Health. 2016. https://doi.org/10.1177/1403494815621181.CrossRef

29.

Babbie E. The practice of social research. 13th ed. California: Cengage learning; 2011.

30.

Ard MC, Raghavan N, Edland SD. Optimal composite scores for longitudinal clinical trials under the linear mixed effects model. Pharm Stat. 2015. https://doi.org/10.1002/pst.1701.CrossRef

31.

Aharony L, Strasser S. Patient satisfaction: what we know about and what we still need to explore. Med Care Rev. 1993. https://doi.org/10.1177/002570879305000104.CrossRef

32.

Asadi-Lari M, Tamburini M, Gray D. Patients’ needs, satisfaction, and health related quality of life: towards a comprehensive model. Health Qual Life Outcomes. 2004. https://doi.org/10.1186/1477-7525-2-32.CrossRef

33.

Creswell JW. Research design: qualitative, quantitative and mixed methods approach. 4th ed. Los Angeles: Sage; 2014.

34.

Chimbindi N, Bärnighausen T, Newell ML. Patient satisfaction with HIV and TB treatment in a public programme in rural KwaZulu-Natal: evidence from patient-exit interviews. BMC Health Serv Res. 2014. https://doi.org/10.1186/1472-6963-14-32.

35.

Gamarel KE, Kuo C, Boyes M, Cluver LD. The dyadic effects of HIV stigma on the mental health of children and their parents in South Africa. J HIV AIDS Soc Serv. 2017. https://doi.org/10.1080/15381501.2017.

36.

Atujuna M, Newman PA, Wallace M, Eluhu M, Rubincam C, Brown B, et al. Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: a qualitative study. PLoS One. 2018. https://doi.org/10.1371/journal.pone.0191251.CrossRef

37.

Nyasulu J, Muchiri E, Mazwi S, Ratshefola M. NIMART rollout to primary healthcare facilities increases access to antiretrovirals in Johannesburg: an interrupted time series analysis. S Afr Med J. 2012. https://doi.org/10.7196/samj.6380.CrossRef

38.

Vawda Y, Variawa F. Challenges confronting health care workers in government’s ARV rollout: rights and responsibilities. PER. 2012;15:01–36.CrossRef

39.

Pebody R. People with TB and HIV in South Africa face a double stigma. 2012. http://www.aidsmap.com/People-with-TB-and-HIV-in-South-Africa-face-a-double-stigma/page/2329334/. Accessed 16 Sept 2017.

40.

Rau A, Wouters E, Engelbrecht M, Masquillier C, Uebel K, Kigozi G, et al. Towards a health-enabling working environment - developing and testing interventions to decrease HIV and TB stigma among healthcare workers in the Free State, South Africa: study protocol for a randomised controlled trial. Trials. 2018. https://doi.org/10.1186/s13063-018-2713-5.

41.

Kang HK. Influence of culture and community perceptions on birth and perinatal Care of Immigrant Women: doulas’ perspective. J Perinat Educ. 2014. https://doi.org/10.1891/1058-1243.23.1.25.CrossRef

42.

Magnus M, Herwehe J, Murtaza-Rossini M, Reine P, Cuffie D, et al. Linking and retaining HIV patients in care: the importance of provider attitudes and behaviors. AIDS Patient Care STDs. 2013. https://doi.org/10.1089/apc.2012.0423.CrossRef

43.

Scheffler, E., et al. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa. Afr J Prim Health Care Fam Med. 2015. doi: https://doi.org/10.4102/phcfm.v7i1.820.

44.

Booysen F, Berg S, van der Burger R, von Maltitz M, du Rand G. Using an asset index to assess trends in poverty in seven Sub-Saharan African countries. World Development. 2008. https://doi.org/10.1016/j.worlddev.2007.10.008 CrossRef

45.

Kambala C, Morse T, Masangwi S, Mitunda P. Barriers to maternal health service use in Chikhwawa, Southern Malawi. Malawi Med J. 2011. https://doi.org/10.4314/mmj.v23i1.67673.

46.

Schoon MG. Impact of inter-facility transport on maternal mortality in the Free State Province. S Afr Med J. 2013. https://doi.org/10.7196/samj.6828.CrossRef

47.

Atuoye KN, Dixon J, Rishworth A, Galaa SZ, Boamah SA, Luginaah I. Can she make it? Transportation barriers to accessing maternal and child health care services in rural Ghana. BMC Health Serv Res. 2015. https://doi.org/10.1186/s12913-015-1005-y.

48.

Mannava P, Durrant K, Fisher J, Chersich M, Luchters S. Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review. Glob Health. 2015. https://doi.org/10.1186/s12992-015-0117-9.

49.

Tsawe M, Susuman AS. Determinants of access to and use of maternal health care services in the eastern cape, South Africa: a quantitative and qualitative investigation. BMC Res Notes. 2014. https://doi.org/10.1186/1756-0500-7-723.CrossRef

50.

Mugglin C, Estill J, Wandeler G, Bender N, Egger M, Gsponer T, et al. Loss to programme between HIV diagnosis and initiation of antiretroviral therapy in sub-Saharan Africa: systematic review and meta-analysis. Tropical Med Int Health. 2012. https://doi.org/10.1111/j.1365-3156.2012.03089.x.CrossRef

51.

Schatz E, Knight L. “I was referred from the other side”: Gender and HIV testing among older South Africans living with HIV. PLoS One. 2018. doi: https://doi.org/10.1371/journal.pone.0196158.CrossRef

52.

Yakubu I, Salisu WJ. Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 2018. https://doi.org/10.1186/s12978-018-0460-4.

53.

Fatti G, Shaikh N, Eley B, Jackson D, Grimwood A. Adolescent and young pregnant women at increased risk of mother-to-child transmission of HIV and poorer maternal and infant health outcomes: a cohort study at public facilities in the Nelson Mandela Bay metropolitan district, Eastern Cape, South Africa. S Afr Med J. 2014. doi:https://doi.org/10.7196/SAMJ.8207.CrossRef

54.

Hodgkinson S, Beers L, Southammakosane C, Lewin A. Addressing the Mental Health Needs of Pregnant and Parenting Adolescents. Pediatrics. 2014;133(1):114–22. https://doi.org/10.1542/peds.2013-0927.CrossRefPubMedPubMedCentral

55.

Emelumadu O, Ukegbu A, Ezeama N, Kanu O, Ifeadike C, Onyeonoro U. Socio-demographic determinants of maternal health-care service utilization among rural women in Anambra state, south East Nigeria. Ann Med Health Sci Res. 2014. https://doi.org/10.4103/2141-9248.133463.CrossRef

56.

Zachariah R, Tayler-Smith K, Manzi M, Massaquoi M, Mwagomba B, van Griensven J, et al. Retention and attrition during the preparation phase and after start of antiretroviral treatment in Thyolo, Malawi, and Kibera, Kenya: implications for programmes? Trans R Soc Trop Med Hyg. 2011. https://doi.org/10.1016/j.trstmh.2011.04.014.CrossRef

57.

Schneider H, Govender V, Harris B, Cleary S, Moshabela M, Birch S. Gender difference in experiences of ART services in South Africa: a mixed methods study. Tropical Med Int Health. 2012. https://doi.org/10.1111/j.1365-3156.2012.03009.x.CrossRef

58.

Madiba S, Ngwenya N. Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa. Glob Health Action 2017; doi: https://doi.org/10.1080/16549716.2017.1341597.CrossRef

59.

Wabiri N, Chersich M, Shisana O, Blaauw D, Rees H, Dwane N. Growing inequities in maternal health in South Africa: a comparison of serial national household surveys. BMC Pregnancy Childbirth. 2016. doi: https://doi.org/10.1186/s12884-016-1048-z.

60.

Nugent R, Bertram MY, Jan S, Niessen LW, Sassi F, Jamison DT, et al. Investing in non-communicable disease prevention and management to advance the sustainable development goals. Lancet. 2018. https://doi.org/10.1016/S0140-6736(18)30667-6.CrossRef

61.

Jardien-Baboo S, van Rooyen B, Ricks E, Jordan P. Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay. Health SA Gesondheid. 2016. https://doi.org/10.1016/j.hsag.2016.05.002.CrossRef

62.

South Africa, National Department of Health. A District Hospital Service Package for South Africa: a set of norms and standards. 2002. http://www.kznhealth.gov.za/norms.pdf. Accessed 8 Aug 2018.

63.

South Africa, National Department of Health. A Comprehensive Health Care Services Package for South Africa. 2003. https://www.westerncape.gov.za/general-publication/comprehensive-health-care-services-package-sa. Accessed 8 Aug 2018.

64.

South Africa, National Department of Justice. Patients’ Rights Charter. 2007. http://www.justice.gov.za/VC/docs/policy/Patient%20Rights%20Charter.pdf. Accessed 8 Aug 2018.

65.

South Africa National Department of Health. National Core Standards for Health Establishments in South Africa. 2011. http://www.cohsasa.co.za/content/national-department-health-national-core-standards-health-establishments-south-africa-0. Accessed 10 Aug 2018.

Title: Patients’ perspectives of acceptability of ART, TB and maternal health services in a subdistrict of Johannesburg, South Africa
Authors: Blaise Joy Bucyibaruta
John Eyles
Bronwyn Harris
Gaëtan Kabera
Kafayat Oboirien
Benon Ngyende
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-018-3625-5

At a glance: The STEP trials

Springer Medicine

Patients’ perspectives of acceptability of ART, TB and maternal health services in a subdistrict of Johannesburg, South Africa

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2018

Safety culture in the primary health care settings based on workers with a leadership role: the psychometric properties of the Slovenian-language version of the safety attitudes questionnaire – short form

Exploring the networking behaviors of hospital organizations

Indigenous land management as primary health care: qualitative analysis from the Interplay research project in remote Australia

Application of discrete event simulation in health care: a systematic review

A person-centered integrated care quality framework, based on a qualitative study of patients’ evaluation of care in light of chronic care ideals

Sexual and reproductive health services (SRHS) for adolescents in Enugu state, Nigeria: a mixed methods approach