Assessment of Antiretroviral Therapy Monitoring Laboratory Services Quality in Governmental Hospitals at Addis Ababa, Ethiopia.
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Date
2011-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: - Despite the fact that Ethiopia is accelerating its ART
program, little is known about the quality of ART monitoring laboratory
services in health facilities.
Objective: - To assess the quality of ART monitoring laboratory services in
public hospitals of Addis Ababa with emphasis on client satisfaction,
providers’ views, functional & structural status of the ART monitoring
laboratory service.
Methods: - Hospital based, descriptive cross sectional study was conducted
from October to November 2010. In this study both quantitative and
qualitative design forms were used. A total of 422 clients were considered for
exit interview about their satisfaction towards ART monitoring laboratory
services using structured questionnaire. To assess the structural and
functional aspects of ART monitoring laboratories, observation checklist was
used. In-depth interview of providers were conducted to assess their views
on quality of ART monitoring laboratory services. Data were coded and
entered using EPI info 2002 (Centers for Disease Control and Prevention
Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC,
Chicago, IL, USA). Satisfaction score was calculated by giving a value of one
for very satisfied. A value of two was assigned for response of satisfied; three
for neutral response. Values of four and five were given for dissatisfied and
very dissatisfied responses respectively. The mean, median and mode scores
for the overall satisfaction were calculated. Median of the summary score of
satisfaction was used to classify as satisfied and none satisfied since the
distribution of summary scores was skewed. Bivariate and multivariate
logistic regression models were also used to examine the effect of selected
variables on patients’ satisfaction with ART monitoring laboratory services by
using Odds Ratio (OR) with a 95% Confidence Interval (CI). P-Value less than
0.05 were taken as statistically significant. Variables that were found with a
statistically significant association (p<0.05) at univariate logistic analysis
were entered and analyzed by multiple logistic regression analysis.
Results: - A total response rate of 406 (96.2%) from 422 sample size was
obtained. Among those 255(62.8%) were females. The overall satisfaction
rate was 47.5%. The major determinants for none satisfaction were lack of
space in blood drawing room to put client personal thing (AOR= 3.377, 95%
CI 1.511-7.550, P=0.00), lack of information regarding bruises following
blood drawing (AOR= 2.029; CI 1.162-3.542, P=0.01 ),waiting time to get
laboratory results (AOR= 4.096; CI 1.769-9.485, P=0.00), needle stick while
attempting to draw blood (AOR=7.769, 95% CI 1.280-47.166, P=0.02),
waiting time to get blood drawing service (AOR= 7.643, 95% CI 2.62722.236,
P=0.00).
None of the
hospital
laboratory
had
guideline
for disposal
of
damaged
or expired
laboratory reagents.
Equipment
maintenance
was
one of
the
major problems
found in
almost all
public
hospital of the
city providing
ART
services
during
in-depth
interview
of
providers.
Conclusion:-The
overall satisfaction
level
of clients
with
ART monitoring
laboratory
services was 47.5%.
Accessibility
and availability of latrines,
ability
of
phlebotomist
to answer
questions
raised
by clients
and
comfort of
chairs
in
blood
drawing
room
were
considered
the
most significant
factors for
low
satisfaction levels.
Equipment
maintenance
was
a major challenge
in
rendering ART monitoring laboratory services in public hospitals.
Description
Keywords
Antiretroviral Therapy ,Laboratory Services,Quality