Twimukye Adelline, King Rachel, Schlech Walter, Zawedde Faridah Mayanja, Kakaire Tom, Parkes-Ratanshi Rosalind
Infectious Diseases Institute, Makerere University, Kampala, Uganda.
University of California, San francisco, CA, 94105, USA.
BMC Health Serv Res. 2017 Aug 22;17(1):580. doi: 10.1186/s12913-017-2524-5.
There has been a rapid scale up of HIV services and access to anti-retroviral therapy in Africa over the last 10 years as a result of multilateral donor funding mechanisms. However, in order to continue to expand and to sustain these services it is important that "in country" options are explored. This study sought to explore attitudes and perceptions of people living with HIV (PLHIV) and health care staff towards using a fee-based "after hours" clinic (AHC) at the Infectious Diseases Institute (IDI) in Kampala, Uganda.
A cross-sectional study design, using qualitative methods for data collection was used. A purposeful sample of 188 adults including PLHIV accessing care at IDI and IDI staff were selected. We conducted 14 focus group discussions and 55 in-depth interviews. Thematic content analysis was conducted and Nvivo Software Version 10 was used to manage data.
Findings suggested that some respondents were willing to pay for consultation, brand-name drugs, laboratory tests and other services. Many were willing to recommend the AHC to friends and/or relatives. However, there were concerns expressed of a risk that the co-pay model may lead to reduction in quality or provision of the free service. Respondents agreed that, as a sign of social responsibility, fees for service could help underprivileged patients.
The IDI AHC clinic is perceived as beneficial to PLHIV because it provides access to HIV services at convenient times. Many PLHIV are willing to pay for this enhanced service. Innovations in HIV care delivery such as quality private-public partnerships may help to improve overall coverage and sustain quality HIV services in Uganda in the long term.
在过去10年里，由于多边捐助资金机制，非洲的艾滋病病毒服务以及抗逆转录病毒疗法的可及性得到了迅速扩大。然而，为了继续扩大并维持这些服务，探索“国内”的选择很重要。本研究旨在探讨艾滋病病毒感染者（PLHIV）和医护人员对在乌干达坎帕拉传染病研究所（IDI）使用收费的“非工作时间”诊所（AHC）的态度和看法。
采用横断面研究设计，使用定性方法收集数据。选取了188名成年人作为有目的的样本，包括在IDI接受治疗的PLHIV和IDI工作人员。我们进行了14次焦点小组讨论和55次深入访谈。进行了主题内容分析，并使用Nvivo软件版本10来管理数据。
研究结果表明，一些受访者愿意为咨询、名牌药品、实验室检查和其他服务付费。许多人愿意向朋友和/或亲戚推荐AHC。然而，有人担心共付模式可能会导致免费服务质量下降或供应减少。受访者一致认为，作为社会责任的一种体现，服务费可以帮助贫困患者。
IDI的AHC诊所被认为对PLHIV有益，因为它在方便的时间提供艾滋病病毒服务。许多PLHIV愿意为这种强化服务付费。艾滋病护理服务的创新，如优质的公私伙伴关系，可能有助于长期提高乌干达的总体覆盖率并维持优质的艾滋病病毒服务。
