Improving quality of service among antiretroviral therapy users through strategic problem-solving approach at bure primary hospital, northwest Ethiopia

Abstract

Background: Globally, an estimated 1.7 million new human immunodeficiency virus (HIV) infections occurred in 2018. Although significant progress has been made still, it remained a public health threat. Thus, this capstone project aimed to improve the quality of services among anti-retroviral therapy (ART) users through a strategic problem-solving approach at Bure Primary Hospital, northwest Ethiopia, 2020. Methods: A before–after study design was employed among 357 people living with HIV (PLWH) clients on ART from December 2019 to January 2020 and from April to May 2020 pre and post capstone project. The capstone project involved regular internal mentorship, availing supplies, and providing refresher training. Data were entered using EPI data version 3.1 and exported to SPSS version 23 statistical for analysis. Paired t-test was used for comparing the mean scores before and after the capstone project. A mean score with 95% CI and a P-value <0.05 were used to determine the effect of the capstone project on the quality of the service. Results: The overall quality of ART service was improved as evidenced by the presence of a positive gap score (+0.0164) according to the SERVQAUL model. Receiving first CD4 count was improved from 65% to 85.1% and screening for TB from 90% to 97% with 95% CI at a p-value of 0.001. Whereas, viral load measurement at six months is 78% to 89.75% and IPT uptake is 62% to 71% with 95% CI at a p-value of 0.013 and 0.004, respectively. Conclusion: Ensuring regular internal mentorship, availing supplies, and providing refresher training have a significant effect on the quality of ART service. Therefore, adhering to national guidelines and fulfilling the availability of the recommended infrastructures helps to improve the quality of ART service.