Satisfaction with HIV care: Comparative assessment between HIV clients in community pharmacies and specialty clinics in Rivers State Nigeria

Abstract

Background: Decentralization is a major HIV care strategy that was implemented in 2016 with the aim of improving the availability and accessibility of HIV care by devolving HIV care services from tertiary health facilities to peripheral centres such as HIV community pharmacies (CP). Aim: This study assessed and compared the satisfaction of stable HIV clients receiving services at community pharmacy and specialist HIV clinic. Patients, Materials and Methods: Comparative cross-sectional study design involving 174 clients in CP and 174 clients in specialty clinics (SCs) in Rivers State, Nigeria was used. Clients' satisfaction was measured using patient satisfaction questionnaire and dichotomized into satisfied and not satisfied. Chi-square test was used for the analysis of “strongly agree” and “agree” responses while Mann–Whitney U test was used to compare client's satisfaction between facilities. Results: Clients attending CP showed higher mean ranks compared to SCs in the general satisfaction (P < 0.001) and financial aspect (P < 0.001) domains while the SCs clients demonstrated higher mean in the interpersonal manners (P = 0.012) and time spent with providers (P < 0.001). Overall, 65.5% and 72.3% of participants were satisfied with HIV care in SCs and CP respectively with a gap of 6.8% in favour of CP (P = 0.117). Conclusion: The study found a higher level of overall client satisfaction for HIV care services received at CP compared to the SCs. These findings emphasize the need for confirmation of this hypothesis using analytic design to inform further decentralization to the remaining Local Government Areas in Rivers State.