Determinants of Satisfaction with Prevention of Mother to Child Transmission Services among HIV Positive Postnatal Mothers Attending Mch/Fp Clinic in Embu Level 5 Hospital, Kenya

Abstract

Fulfillment of patient/client needs and desires through the delivery of health care is perceived as satisfaction. This study aimed at establishing determinants of satisfaction with Prevention of Mother to Child Transmission services among HIV positive postnatal mothers in Embu County hospital, Kenya. Mixed study design that combined analytical cross-sectional study for quantitative data and phenomenological design for qualitative data was used. The specific objectives were to; establish satisfaction level of HIV positive postnatal mothers with PMTCT services; identify client, provider and facility related factors influencing HIV positive postnatal mother satisfaction with PMTCT services. Census sampling was used to sample HIV positive postnatal mothers who were to provide quantitative data obtained using the questionnaire. Purposive sampling was used to sample participants who participated in focus group discussion. Analysis was done through cross-tabulation, chi-square, and logistic regression analysis. Research findings were presented in pie charts, graphs, and tables. The study achieved a response rate of 92.5% which was considered satisfactory in generalizing the study findings. From the cross-tabulation and chi-square analysis, two independent variables (provider (p-value of 0.001) and facility-related factors (p-value of 0.030) had significant association with client satisfaction while in the client-related factors only marital status (p-value of 0.039) had a significant association with client satisfaction. In relation to the patient satisfaction, facility related factors were rated the highest at an average rate of 97.3 %( n=72/74). From the logistic regression analysis, three variables (marital status, counselling, and male involvement) were significantly associated with patient satisfaction. Provider related factors were associated with over 4% change/variance in participant satisfaction. Qualitative data from the FGD showed that majority of the respondents were satisfied but needed some slight changes including time management and staffing to reduce time wastage. The recommendations include Financing and training of health care workers, Quality Assurance and Quality Improvement implementation, addressing human resource for health gaps, provision of comprehensive Counselling and scale up partner involvement especially male partners is highly recommended in improving and sustaining client satisfaction on PMTCT services. Further studies and periodic assements on client satisfaction on PMTCT services is highly recommended.