Quality of STIs and HIV/AIDS care as perceived by biomedical and traditional health care providers in Zambia: Are there common grounds for collaboration?

• Published in: Complementary therapies in medicine Vol. 16; no. 3; pp. 155 - 162
• Main Authors: Kaboru, Berthollet Bwira, Muchimba, Maureen, Falkenberg, Torkel, Höjer, Bengt, Faxelid, Elisabeth
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-06-2008; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - therapy; AIDS; Attitude of Health Personnel; Chronic illnesses; Collaboration; Cooperative Behavior; Cross-Sectional Studies; Health care; Health Care Surveys; Health facilities; Health sciences; Health Services, Indigenous - organization & administration; Health workers; HIV; HIV Infections - therapy; HIV/AIDS; Human immunodeficiency virus; Humans; Integrative medicine; Internal Medicine; Interprofessional Relations; Interviews; Medical Education; Medicin och hälsovetenskap; Medicine; Medicine, African Traditional; Needs Assessment; Palliative care; Public health; Quality of care; Quality of Health Care; Sexually Transmitted Diseases - therapy; STIs; Studies; Traditional healers; traditional heaters; Zambia; Zambia; HIV/AIDS; Traditional healers; Collaboration; Zambia; STIs; Quality of care; Health workers; Integrative medicine
• ISSN: 0965-2299; 1873-6963; 1873-6963
• DOI: 10.1016/j.ctim.2008.02.005

Summary Objective To explore biomedical and traditional health care providers’ (BHPs and THPs, respectively) perceptions of good quality of care and opinions on weaknesses in the services they provide to patients with STIs and HIV/AIDS. Methods Using data from a cross-sectional survey, we post-coded two open-ended questions related to THPs’ and BHPs’ perceptions on good quality of care and on provided care. The post-coding was done following Donabedian's framework of assessment of quality of care, and allowed transformation of qualitative data into quantitative. The analysis is based on comparison of frequencies, proportions and subsequent chi-square tests and odds ratios. Setting Ndola and Kabwe, Zambia Main measures: Proportions of responses from 152 BHPs and 144 THPs. Results Substantial proportions of providers from both sectors perceived drugs availability (63% of BHPs and 70% of THPs) and welcoming attitude (73% of BHPs and 64% of THPs) as important components of good quality care. BHPs were more likely than THPs to mention proper examination, medical management (provider's technical ability) and explanation of causes and prognosis of the disease as important. More THPs than BHPs cited short waiting time and cost of care. A majority of BHPs (87%) and of THPs (80%) reported deficiencies in their STIs and HIV/AIDS-related services. Both groups regarded training of providers and nutritional support and health education to patients as lacking. None of the THPs alluded to voluntary counselling and testing (VCT) or supportive/home-based care as aspects needing improvement. Conclusion Drugs availability and welcoming attitude were two aspects of quality highly valued by THPs and BHPs. Future collaborative interventions need to respond to aspects of joint concern including training of providers, nutritional support and health education to patients. Further, there is an imperative of expanding and adapting VCT, home-based care and palliative care to THPs for better care of STIs and HIV/AIDS.