Navigating the healthcare system in Nairobi City County: perspectives and experiences in the utilization of oral healthcare by caregivers of children with HIV/AIDS.

Autor: Masiga MA; Department of Dental Sciences, Faculty of Health Sciences, University of Nairobi, P.O Box 48792-00100, Nairobi, Kenya. ati_masiga@yahoo.com., Wandibba S; Institute of Anthropology, Gender & African Studies, University of Nairobi, Uhuru Gardens, P.O. Box 474-00517, Nairobi, Kenya.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2022 Jul 29; Vol. 22 (1), pp. 964. Date of Electronic Publication: 2022 Jul 29.
DOI: 10.1186/s12913-022-08260-3
Abstrakt: Background: The healthcare system in any republic can cause inequalities in health outcomes if they do not take into account the needs of deprived populations. Children with HIV/AIDS are known to have a high vulnerability to oral diseases; yet, they continue to face limitations in the utilization of oral healthcare. While other determinants of healthcare utilization may co-exist, possible gaps in the oral healthcare system can collectively affect a vulnerable group disproportionately in the utilization of oral healthcare.
Objective: To explore qualitatively, the perspectives, experiences and attributions of a cohort of caregivers of children with HIV/AIDS and their Health Care Providers (HCPs), on the utilization of oral healthcare within the structure of the oral healthcare system in Nairobi City County (NCC).
Design: A cross-sectional explorative mixed methods study design of two hundred and twenty one (221) female caregivers of children with HIV/AIDS and their HCPs using a survey, Focus Group Discussions (FGDs) and In-depth Interviews (IDIs). The study setting was the HIV-Care Facilities (HIV-CCFs) at three large hospitals in NCC.
Results: Caregivers mainly utilized independent 'nearby' private dental clinics for oral healthcare services, attributing their selection to cheaper user-fees, proximal service location, and recommendations from social networks. Wait time, opening and closing hours, health workers' attitudes and inferred opportunity costs were perceived as important quality issues in the utilization of oral healthcare.
Conclusion: The oral healthcare system in NCC does not support the utilization of oral healthcare within the context of providing comprehensive healthcare for children with HIV/AIDS. Absence of 'in-house' oral health services at the HIV- CCFs is viewed as a defining structural barrier.
(© 2022. The Author(s).)
Databáze: MEDLINE
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