USAID Transform: Primary Health Care Activity, JSI Research & Training Institute, Inc. in Ethiopia, P.O. Box 1392, 1110, Addis Ababa, Ethiopia.
Department of Health Studies, University of South Africa (UNISA), Pretoria, South Africa.
Malar J. 2021 Mar 17;20(1):153. doi: 10.1186/s12936-021-03694-2.
Malaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate adult malaria patients and healthcare providers' perception of the quality of malaria management at private sector outpatient facilities.
An exploratory, descriptive, contextual and qualitative research methodology was conducted with 101 participants (33 in-depth interviews (INIs) and ten focus group discussions (FGDs) with 68 participants). All interview and focus group discussions were audio recorded, transcribed verbatim and analysed, using eight steps of Tesch.
During data analysis a single theme, two categories and six sub-categories emerged, namely (1) perceived quality of malaria management at outpatient facilities; (a) essential resources; (a1) safe outpatient services; (a2) anti-malarial drugs and supplies; (a3) health workers; (b) factors influencing service utilization; (b1) physical accessibility; (b2) "art of care''; and (b3) efficient malaria diagnosis and treatment services. Both FGDs and INIs participants had a positive perception of the quality of malaria outpatient services at private health facilities. The positive perceptions include safe and clean facility; availability of supplies and comprehensive services; convenient working hours; short waiting hours and motivated, competent and compassionate health workers. However, some participants raised their safety concerns due to perceived poor infection control practices, small working areas, interruption of anti-malarial supplies and inefficient malaria diagnosis and treatment services.
Both community members and healthcare providers had more positive perceptions towards outpatient malaria services offered at private health facilities. However, positive behaviour must be maintained and concerns must be dealt with by enhancing functional public private partnership for malaria care services to improve private sector malaria case management; build the service providers' capacity; ensure uninterrupted anti-malarial supplies and empower the community with early health-seeking behaviour.
疟疾是埃塞俄比亚最重要的公共卫生问题之一，导致了大量患者的发病率和死亡率。通过公立、私立和社区卫生机构及时诊断和有效管理疟疾病例，是疟疾防控和消除策略的关键之一。本研究旨在评估私营部门门诊医疗机构中成年疟疾患者和卫生保健提供者对疟疾管理质量的看法。
采用探索性、描述性、情境性和定性研究方法，对 101 名参与者（33 名深入访谈（INIs）和 10 个焦点小组讨论（FGDs）共 68 名参与者）进行了研究。所有访谈和焦点小组讨论都进行了录音，逐字转录并进行分析，采用了 Tesch 的八个步骤。
在数据分析过程中，出现了一个主题、两个类别和六个子类别，即（1）门诊设施中疟疾管理的感知质量；（a）基本资源；（a1）安全的门诊服务；（a2）抗疟药物和用品；（a3）卫生工作者；（b）影响服务利用的因素；（b1）物理可达性；（b2）“关怀艺术”；（b3）高效的疟疾诊断和治疗服务。焦点小组讨论和 INIs 参与者对私立卫生机构的门诊疟疾服务质量都有积极的看法。积极的看法包括安全、清洁的设施；供应品和综合服务的可用性；便利的工作时间；短的等待时间；有积极性、能力和同情心的卫生工作者。然而，一些参与者提出了对感染控制做法差、工作区小、抗疟药物供应中断以及疟疾诊断和治疗服务效率低下的担忧，从而对安全表示关注。
社区成员和卫生保健提供者对私立卫生机构提供的门诊疟疾服务都有更积极的看法。然而，必须保持积极的态度，通过加强功能良好的公私伙伴关系来处理关切问题，以改善私营部门的疟疾病例管理；增强服务提供者的能力；确保抗疟药物供应不间断，并使社区具备早期求医行为。
