Ads: Get Admission into 200 Level and Study any Course in any University of Your Choice. Low Fees | No JAMB UTME. Call 09038456231

A Study on the Quality of Care Assessment of Hiv/Aids Patients in Gwamna Awan General Hospital, Kakuri Kaduna State

ADS! DOWNLOAD ANY PAST QUESTIONS AND ANSWERS (PDF VERSION)


A Study on the Quality of Care Assessment of Hiv/Aids Patients in Gwamna Awan General Hospital, Kakuri Kaduna State.

ABSTRACT

Background: The study was carried out at Mallam (Dr) Gwamna Awan General Hospital Kakuri, Kaduna with the aim of improving the quality of services rendered to HIV/AIDS patient and to determine the factors affecting utilization and patient satisfaction with available services.

Assessment of quality from the perspective of healthcare provider and managers, and thus, the study was conducted from 25th April – 27th May 2011.

Methodology: The study was a cross-sectional descriptive study that looked at the structural dimension of quality care, providers, managers and client dimensions of quality of HIV/AIDS services.

A checklist adapted from the minimum requirements for a primary health centre developed by the National Primary Healthcare Development Agency was used in assessing the health resources available for HIV/AIDS health services in Gwamna Awan General Hospital Kakuri, Kaduna. All the providers present were included in the study to heir their view on various perspective of care.

In addition, a total of 402 client selected by stratified sampling with proportionate allocation were interviewed using a questionnaire.

Results The results from the study showed 78.03% of client interviewed rated the quality of care good, 61.69% of respondents rated the availability of facilities.

TABLE OF CONTENTS

Title – – – – – – – – – – i
Dedication – – – – – – – – – – ii
Declaration – – – – – – – – – – iii
Certification – – – – – – – – – – iv
Acknowledgment – – – – – – – – – v
Abstract – – – – – – – – – – vi
Table of Contents – – – – – – – – – vii
List of Tables – – – – – – – – – – viii
List of Figures – – – – – – – – – – ix

Chapter One
1.0 Introduction – – – – – – – – – 1
1.1 Justification – – – – – – – – – 4
1.2 Problem of statement – – – – – – – – 5
1.3 General Aims – – – – – – – – 7
1.4 Specific Objective – – – – – – – – 7
1.5 Scope of the study – – – – – – – – 7

Chapter Two
2.1 Literature review – – – – – – – – 10
2.11 Evolution of quality assurance in health care industry – – – 10
2.3 Perspective of quality of care – – – – – – – 12
2.13 Quality dimensions – – – – – – – – 16
2.131 Quality assurance – – – – – – – – 16
2.132 Quality control – – – – – – – – 17
2.133 Total quality management (TQM) – – – – – – 17
2.14 Tools for measuring quality of HIV/AIDS care – – – – 17
2.141 The quote document – – – – – – – – 18
2.2.3 Availability of equipment, drugs and supplies – – – – 27

Chapter Three
3.1 Background to the study area – – – – – – – 30
3.2 Sampling techniques – – – – – – – – 33
3.3 Sampling size determination – – – – – – – 33
3.4 Methods of data collection – – – – – – – 34
3.5 Data analysis – – – – – – – – – 36
3.6 Ethical issues – – – – – – – – – 37

Chapter Four
4.1 Quality of care in the perspective of the client – – – – 38
4.2 Distribution of socio-demographic date of participant – – – 39

Chapter Five
5.1 Discussion – – – – – – – – – 61
5.2 Quality of care in the perspective of the client – – – – 61
5.3 In the perspective of the OPD staff – – – – – – 63
5.4 In the perspective of the Health Manager – – – – – 64
5.5 Comparing the quality of care in perspective of the clients, and the health
manager and the health care provider- – – – – – 66

Chapter Six
6.1 Conclusions and recommendations – – – – – – 68
6.2 Conclusions – – – – – – – – – 68
References – – – – – – – – – – 71
Appendix – – – – – – – – – – 75

LIST OF TABLES
Table 1: Quality of care in the perspective of the client – – – 38
Table 2: Distribution of participants’ opinion on quality of care rating – 44
Table 3: Patient waiting time before seeing the doctor- – – – 44
Table 4: Attitude of the doctor to their patient during consultation – – 45
Table 5: Need for the doctor to listen to the patient before examination – 51
Table 6: Physical examination of patient by the doctor – – – 45
Table 7: Requesting for relevant investigation at the consulting room – 46
Table 8: The doctor telling whether or not to return for follow-up – – 46
Table 9: Privacy during OPD consultation – – – – 47
Table 10: Confidentiality at the OPD consultation – – – – 47
Table 11: The general cleanliness of the hospital for an outpatient care – 48
Table 12: Patient waiting time at the card room before patient gets care – 48
Table 13: Patient waiting time at the consulting room to see the doctor – 49
Table 14: Patient waiting time at the pharmacy before given attention – 49
Table 15: Patient waiting time at the laboratory before given attention – 50
Table 16: Patient waiting time at the treatment room before given attention – 50

 

INTRODUCTION

Quality means different things to different people. English dictionaries have defined quality differently ranging from valued commodity, conforming to specifications, doing right things at the right time etc.1 Quality of care is defined as the ability of the health care to meet the needs of the users and service provides in an equitable and acceptable manner at affordable cost all the time, within the resources available and in line with the existing policies.

It is of immense interest to note that quality can be improved without necessarily injecting additional human or material resources. A high quality of care is essential to improve utilization of healthcare service in order to reduce the prevalence of diseases and health problems in the society, especially that today clients are more aware of their rights, quality and cost of care.

The provision of care depends on the availability of users/clients. Without patronage, services will be useless even if provided free. Consequently, satisfaction is of paramount importance. The provision of service is highly associated with the provider and the material resources available to him.

In short, to provide quality service requires: Financial resources, which is a fundamental requirement; adequate human resources including their knowledge skill and competence and reasonable staff attitude, adequate material resources like essential drugs, laboratory services and equipment. These are the essential ingredients of quality of care, which guarantee client satisfaction.

Achievement of quality of care is simply by translating the various processes into desirable outcomes. In other words, it is the process of transformation of client wants, needs and expectation within an organization which the patient derives satisfaction.5 In most developing countries, quality of health care has become a very important issue. Patients demanded to be informed, they have started to ask questions and begun to challenge the information given to

 

them by the health care provider’s. The health care system is publicly criticized and challenged. Health care costs are increasing too rapidly. For these, reasons productivity and quality are major problems and have become the focus of attention.

Under the prevailing condition of ever increasing health care cost, and reduction rate of economic growth, hospitals as the main spenders within the health system are in the limelight.

Government and international organizations are beginning to question the performance of the health centers/hospital particularly those better endowed within each country. Are they really showing the patients’ health care needs? Have standards been developed with regard to prevention, diagnosis and therapeutic services carried out in them?

And if so how well are those standards met? At the same time there are complaints that health care development does not currently place sufficient emphasis on the principles of equity, effectiveness, efficiency, quality of services and consumer satisfaction.

In any managed care plan, the imperative to contain cost must be balanced against the responsibility to provide high-quality care. Particularly for a complex, costly and potentially deadly disease such as HIV/AIDS, managed care plans must ensure that HIV care is of the highest quality.9

Three aspects of medical care can be used to measure its quality; outcomes, processes, and structure of care. Outcome measures are the most important of the three but the most difficult to use. Many outcome measures for HIV/AIDS are sensitive to the severity of disease within a given population, necessitating careful adjustment.

Patient factors such as adherence to medical regimens may also influence outcomes, but it is difficult to adjust for differences in the type of characteristic.

Outcome that occurs infrequently such as death requires that a substantial number of patient be observed over a long enough period of time to detect meaningful differences in quality of care. Processes of care measures are easier to use than outcome measures, making them an attractive alternative for assessing quality. To use process measures, charts or computerized

records are analyzed to determine whether patient got the types of medical care that are thought  to improve patient outcomes, such as recommended prophylaxis for opportunistic infections, disease monitory such as CD4 counts, and indicated anti retro-viral treatments.

Structure of care measures of quality include the accessibility of practice, the availability of a physician on call 24hours a day, and adequate support from case managers, social workers and nutritionists. Again, it is important to be sure that the structure of care being assessed truly affects patients’ outcomes. One structural parameter that has been clearly demonstrated to affect outcome is the amount of experience practitioners have in treating HIV/AIDS.9

Mallam (DR) Gwamna Awan General Hospital was established in 1975. It has 424 staff’s and five clinical departments, 119 inpatients beds with an annual turnover of about 150,000 patients. This project sets out to find the current status in this hospital and to assess the quality of services rendered to HIV/AIDS infected patient.

REFERENCES

New Oxford Dictionary, 8th ed, pp

Haran D. Getting to trip with quality in Jigawa, 1st quarter report 2004, 4

Haran D. Getting to trip with quality in Jigawa, 1st quarter report 2004, 7

Huezo C. and Diaz S. (1993): Quality of care in family planning: client rights and providers needs a duances in contraception a (13-134)

US Government Guideline on Total Quality Management for Senior Managers and Policy – Makers (1997)

Albin (2000) Quality   definition by   different     groups. Hospital          management international. P-83-85

Aguilar M. C. (1994) measuring the performance of hospitals and health centers. WHO/SHS/DHS 94.2

Alan R. N. (1985); Measuring performance and improving quality, Hospital Management International 81-82

Bruce S and Frederick M. H. (1997) AIDS Clinical Care P-14-17

Bello U. (1994) effect of inadequate funding of the health sector on health

Epidermiological fact sheet Nigeria, update 2004. Geneva: UNAIDS 2004

UNAIDS/WHO. Report on the global HIV/AIDS epidemic 2008. Geneva

The Population Council, Inc. 2007. The experience of married adolescent girls in Northern Nigeria:

Leatherman S. and Mc Carthy D.(2002): Improving quality of health care services. P-33- 43

park, kumar, text book of preventive and social medicine, 18thed. History of medicine 23

McColl E, Lois Thomas, A study to determine patient satisfaction with nursing care standards, 1996, Journal of quality of care, 10, 52, 34 – 38

Olumide E.E A, Ajayi I.O 1999, Are the patients safe and satisfied in the PHC in Nigeria, The Journey so

Sambo, M.N. lecture note for MPH class 2009

Sambo, M.N. assessment of quality of care of primary health facilities in Tafa LGA Niger State, 2004, 68

Sambo MN, Lewis, I, Sabitu, K. Status of equipment in primary health centres of Tafa LGA, North Central Nigeria, Sahel Medical Journal 2006; 8(4):83-87.

Blumenthal D. Quality of care – what is it? New England Journal of Medicine, 1996, 335 (12); 891-893. Downloaded from njm.org.at.Hinari Phase 1 sites – Accessed 24/12/07.

Roemer, ML and Montoya-Aguilar, C. Quality Assessment and Assurance in primary health care, WHO Offset Publication No. 105, WHO, 1988;3-6.

Banta D. Quality healthcare in Europe, Euro Health, 2000/2001, 6(5): 18-19.

Nicholas, DD, Heiby, JR, Hartzell, TA. The quality assurance project; Introducing quality improvement to PHC in less-developed countries, Quality Assurance in Healthcare, 1991,3(3); 147-165.

Zeitz, PS, Salami, CG, Burnham, G Goings, SA(et al), Quality Assurance Management methods applied to a local level primary healthcare system in rural Nigeria, International Journal of Health Planning and Management, 1993,8; 235-244.

Brook, RH, McGlynn EA, Shekelle, PG, Defining and measuring quality of care: a perspective from US researchers, International Journal for Quality in Healthcare 2000; 12(4); 281-295.

Brook, RH, McGlynn EA, Cleany, PD. Quality of health care: measuring quality of care. The New England Journal of Medicine, 1996, 335(13):966-970.

Maurajadeh S, Qutob R, Road F. The Assessment of quality of care in prenatal sevices, the female clients and the healthcare provider, IDRC 1995. CD-ROM Medical and health Library 1.1, December

MCLaughlin, CP and Kaluzung, AD. Total Quality Management in health: Making it work, Healthcare management Review, 1990, (3):7-14.

World Health Organization, Report of the Secretary General: road Map Towards the implementation of the United Nations Millennium Declaration, World Health Organization, 2004. Available at int/mdg.accessed.20/12/07.

Kerssens, J. Comparison of patient evaluations of healthcare quality in relation to WHO measures of achievement in 12 European countries, Bulletin of the WHO, 2004, 82(2); 11145-1155.

 

Enter your email address:

Delivered by TMLT NIGERIA

Join Over 3,500 000+ Readers Online Now!


=> FOLLOW US ON INSTAGRAM | FACEBOOK & TWITTER FOR LATEST UPDATES

ADS: KNOCK-OFF DIABETES IN JUST 60 DAYS! - ORDER YOURS HERE

COPYRIGHT WARNING! Contents on this website may not be republished, reproduced, redistributed either in whole or in part without due permission or acknowledgement. All contents are protected by DMCA.
The content on this site is posted with good intentions. If you own this content & believe your copyright was violated or infringed, make sure you contact us at [[email protected]] to file a complaint and actions will be taken immediately.

Tags: , , , ,

Comments are closed.