Client Satisfaction with HIV Care and Treatment services in Western Kenya

Abstract

Client satisfaction towards HIV care and treatment services is a tool that fosters attention and value amongst both People living with HIV (PLHIVs) and health care providers. Clients who are satisfied have a higher chance of adhering to prescribed behavioral and biomedical regimens. Today, client satisfaction measurement has gained relevance in the prediction of healthprograms performance, apart from providing insight for improved service delivery. This study sought to establish the level of client satisfaction to HIV care and treatment services among PLHIVs in Kisii County, Western Kenya. Methods: 340 PLHIVs across 9 health facilities and 6 Key informants, mainly HIV managers and programmers were interviewed in Kisii County, Western Kenya.Results: Most PLHIVs (84%) are satisfied with services as offered at Comprehensive HIV Care Clinics (CCC), indicating these as either good or excellent. Females depict higher service satisfaction level as compared to males; 89% of females rate services provided at comprehensive HIV clinics as either good or excellent compared to 77% males. This study found association betweenclient satisfaction and sex (p = 0.019) with more males rating the CCC services as fair rather than good or excellent, as compared to females. Key informants attributed this to the fact that more clients attending the ART clinics are female, raising possibility that some aspects in services offered are not well engendered. No association was found between client satisfaction and age, education, marital status, religion, parity and sources of income as well as HIV related knowledge and attitudes. Association was however found between client satisfaction and the level of health facility attended (p = 0.001), where respondents in tier 2 health facilities (lower level facilities) were more likely to rate the CCC services as excellent. Key informants attributed this to the better patient to clinician ratio in tier 2 facilities that allows more contact between patients and health workers compared to higher level facilities. This study found that most PLHIVs (83%) went for their comprehensive care clinic appointments either before or on the date of appointment. Conclusions and Recommendations: To foster client satisfaction, HIV programmers should ensure the right patient - clinician ratios. It is necessary to further review male client satisfaction for in-depth understanding of their low satisfaction levels as compared to females.