卫生系统应对艾滋病毒和残疾人在乌干达西南部。

IF 1.5 Q4 INFECTIOUS DISEASES
Emmanuel Kibet, Florence Namirimu, Felista Nakazibwe, Arnold Zironda Kyagera, Disan Ayebazibwe, Bernard Omech
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引用次数: 0

摘要

背景:残疾人(PWD)获得人类免疫缺陷病毒/获得性免疫综合征(艾滋病毒/艾滋病)治疗和护理服务(HATCS)的机会不公平,是到2030年结束这一流行病的一个障碍。本研究的目的是评估乌干达西南部卫生机构中残疾人参加HATCS的卫生系统反应性(HSR)和相关因素。方法:在2022年2月至4月期间,我们从选定的初级保健HIV诊所招募了106名残疾人和14名关键信息提供者进行定量研究。采用世界卫生组织多国研究残疾评估表2.0和卫生系统响应性(HSR)问卷分别测量残疾水平和响应性。采用描述性分析评价HSR水平。通过二元和多变量logistic回归评估社会人口统计学、残疾水平与高铁之间的关系。采用访谈法对14名关键举报人进行定性数据收集,并按主题领域(演绎法)进行分析。结果:总体而言,乌干达西南部艾滋病毒感染者和残疾人可接受的卫生系统响应率(HSR)为47.62%。在不同的领域中,表现最好的是社会考虑(68.57%)和自主性(67.62%)。表现最差的是尊严(2.83%)、保密(2.91%)、及时关注(17.35%)和选择(30.48%)。而通信表现(53.92%)和基础设施质量(42.27%)为平均水平。没有社会人口统计学或残疾变量可以预测HATCS的反应性。残疾人士在康复中心服务期间缺乏社会支持、沟通不畅、被污名化和受到歧视。另一方面,保健提供者因无法与残疾人士有效沟通和满足他们对社会支持的需求而感到沮丧。结论:高铁评分相对较低,尊严、保密、及时关注、选择排名最差。为了解决残疾人士在获得护理方面的普遍和合法需求,需要采取紧急举措,提高所有利益攸关方的认识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Health System Responsiveness for Persons with HIV and Disability in South Western Uganda.

Health System Responsiveness for Persons with HIV and Disability in South Western Uganda.

Health System Responsiveness for Persons with HIV and Disability in South Western Uganda.

Health System Responsiveness for Persons with HIV and Disability in South Western Uganda.

Background: Inequitable access to Human Immunodeficiency Virus/Acquired Immune Syndrome (HIV/AIDS) Treatment and Care Services (HATCS) for People With Disabilities (PWD) is a hurdle to ending the pandemic by 2030. The aim of this study was to evaluate the Health System's Responsiveness (HSR) and associated factors for PWD attending HATCS at health facilities in South Western Uganda.

Methods: Between February and April 2022, we enrolled a total of 106 people with disabilities for a quantitative study and 14 key informants from selected primary care HIV clinics. The World Health Organization Multi-country study's disability assessment schedules 2.0 and Health system responsiveness (HSR) questionnaire were adopted to measure the level of disabilities and responsiveness, respectively. The level of HSR was evaluated using descriptive analysis. The association between socio-demographics, level of disabilities and HSR was evaluated through binary and multivariable logistic regression. The qualitative data were collected from 14 key informants using interview guide and analyzed according to thematic areas (deductive approaches).

Results: Overall, Health system responsiveness (HSR) was at 47.62% being acceptable to people living with HIV and Disabilities in south western Uganda. Across different domains, the best performance was reported in social consideration (68.57%) and autonomy (67.62%). The least performance was registered in dignity (2.83%), confidentiality (2.91%), prompt Attention (17.35%) and Choices (30.48%). Whereas performance in communications (53.92%) and quality of basic amenities (42.27%) were average. There were no socio-demographics or disability variables that were predictive of HATCS responsiveness. PWDs experienced lack of social support, poor communication, stigma and discrimination during the HATCs services. On the other hand, the health-care providers felt frustrated by their inability to communicate effectively with PWDs and meet their need for social support.

Conclusion: HSR was comparatively low, with dignity, confidentiality, prompt attention, and choice ranking worst. To address the universal and legitimate requirements of PWDs in accessing care, urgent initiatives are required to create awareness among all stakeholders.

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来源期刊
CiteScore
3.00
自引率
6.70%
发文量
61
审稿时长
16 weeks
期刊介绍: About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.
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