Quality of STIs and HIV/AIDS care as perceived by biomedical and traditional health care providers in Zambia: are there common grounds for collaboration?
OBJECTIVE
To explore biomedical and traditional health care providers' (BHPs and THPs, respectively) perceptions of good quality of care and opinions on weaknesses in the services they provide to patients with STIs and HIV/AIDS.


METHODS
Using data from a cross-sectional survey, we post-coded two open-ended questions related to THPs' and BHPs' perceptions on good quality of care and on provided care. The post-coding was done following Donabedian's framework of assessment of quality of care, and allowed transformation of qualitative data into quantitative. The analysis is based on comparison of frequencies, proportions and subsequent chi-square tests and odds ratios.


METHODS
Ndola and Kabwe, Zambia Main measures: Proportions of responses from 152 BHPs and 144 THPs.


RESULTS
Substantial proportions of providers from both sectors perceived drugs availability (63% of BHPs and 70% of THPs) and welcoming attitude (73% of BHPs and 64% of THPs) as important components of good quality care. BHPs were more likely than THPs to mention proper examination, medical management (provider's technical ability) and explanation of causes and prognosis of the disease as important. More THPs than BHPs cited short waiting time and cost of care. A majority of BHPs (87%) and of THPs (80%) reported deficiencies in their STIs and HIV/AIDS-related services. Both groups regarded training of providers and nutritional support and health education to patients as lacking. None of the THPs alluded to voluntary counselling and testing (VCT) or supportive/home-based care as aspects needing improvement.


CONCLUSIONS
Drugs availability and welcoming attitude were two aspects of quality highly valued by THPs and BHPs. Future collaborative interventions need to respond to aspects of joint concern including training of providers, nutritional support and health education to patients. Further, there is an imperative of expanding and adapting VCT, home-based care and palliative care to THPs for better care of STIs and HIV/AIDS.
Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Bwira.Kaboru@ki.se <Bwira.Kaboru@ki.se>
Berthollet Bwira
BB
Kaboru
Maureen
M
Muchimba
Torkel
T
Falkenberg
Bengt
B
Höjer
Elisabeth
E
Faxelid
D000163:Acquired Immunodeficiency Syndrome / Q000628:therapy; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000628:therapy*; D019538:Health Care Surveys; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D016488:Medicine, African Traditional; D020380:Needs Assessment; D011787:Quality of Health Care; D012749:Sexually Transmitted Diseases / Q000628:therapy*; D015024:Zambia