International AIDS Conference 17 July 2016

Are the men more visible in church health facilities?

P ro g ra m m e M a n a g e r Z i m b a bwe A s s o c i a t i o n o f C h u rc h Re l a te d

H o s p i t a l s ( Z AC H )E m a i l : n z o u @ z a c h . o r g . z w

D r C h i d z e w e r e N z o uM B C h B , M S c . C l i n i c a l E p i d e m i o l o g y

Presentation Outline…

1. Introduction 2. Brief background information

3. Characteristics of respondents

4. Medicines related factors

Presentation Outline…

5. Personal related factors 6. Health facility related factors

7. Socio-economic related factors

8. Conclusion

Introduction

PART ONE

. ZACH has 135 mission institutions

. Mission hospitals make up to 25% of the 1,080 national health facilities. Mission hospitals contribute 38% of the 18,200 national hospital bed capacity also contributing up to 68% of the rural hospital bed capacity. . 70% of Zimbabwe’s population lives in rural areas, these mission health facilities play a key role in rural health service provision. Survey on “Causes of Treatment Interruptions among HIV infected patients defaulting on anti-retroviral therapy in Zimbabwe”.Carried out at four mission hospitals which ZACH members

Brief background information

PART TWO

• Cross sectional, exploratory study• Questions were administered via phone

call and/or face to face • Participants were adults HIV clients on ART

for a period of more than 6 months, who have defaulted ART for more than 2 weeks.

• Systematic random probability sampling method was used to allows each ART defaulter to have an equal chance

• A total of 125 ART defaulters were recruited in the study.

• The sample size was calculated based on the following assumptions; 12% prevalence of non-adherence among clients on ART (existing national data), anticipating a standard error of 0.0378 and to maintain a 95% confidence interval.

• Ethical approval was granted by Medical Research Council of Zimbabwe

Name of Mission Hospital

Bed Capacit

y

Catchment

Population

Daily OPD

Attendance

Active HIV

clients in care

Active ART client

s

Defaulters (Last 3 month)

Survey participan

ts

St. Michaels Mission Hospital

120 4529 50 869 839 40 32

Mt. St. Marys Mission Hospital

130 74210 72 828 796 50 41

Nhowe Mission Hospital

79 20489 30 1341 1290 35 28

St Pauls Musami Mission Hospital

150 20758 70 2698 2639 30 24

TOTAL 479 119986 222 5736 5564 155 (2,7%)

125

Clients In care Clients on ART 0

1000

2000

3000

4000

5000

6000

7000

Men ; 2256 Men ; 2266

Females ; 3680 Females ; 3698

5936 5964

PLHIV in Care and ART

Characteristics of respondents

PART THREE

Demographic characteristics

N/% Min Age (Years)

Max Age (Years)

Mean Age

Male 51(41%) 18 74 43 (SD 14)

Female 74(59%) 18 66 35 (SD11)

Totals 125 (100%) 38(SD 12)

Demographic characteristics of the respondents

Level of education of the respondents

Demographic characteristics

Primary Education

Secondary Education

Tertiary Education

Illiterate

Male 10 (8%) 30(24%) 5(4%) 6(4.8%)

Female 12(9.6%) 45(36%) 10(8%) 7(5.6%)

Totals 22(17.6%) 75(60%) 15(12%) 13(10.4%)

Religion affiliations Demographic characteristics

Catholic Protestant Muslim Other Religions

Male 8(6.4%) 10(8%) 2(1.6%) 30(24%)

Female 8(6.4%) 20(16%) 2(1.6%) 45(36%)

Totals 16(12.8%) 30(24%) 4(3.2%) 75 (60%)

Catholic Protestant Muslim Other 0

10

20

30

40

50

60

70

80

Total Males Females

Medicines related factors

PART Four

Medicines related factors

0

5

10

15

20

25

30

Frequency Males Females

PART Five

Personal Related factors

Personal related factors

0

2

4

6

8

10

12

14

Total Males Females

Personal related factors

0

5

10

15

20

25

30

35

Total Males Females

PART Six

Health Facility related factors

Health facility related factors

0

10

20

30

40

50

60

Total Males Females

PART Seven

Socio-economic related factors

Socio-economic related factors

0

10

20

30

40

50

60

Total Males Females

PART Eight

Conclusion

> There is need for deliberate strategies among the hospitals to offer men friendly services e.g.

. During weekends

. Times convenient to men e.g. after hours

. Efficient service without delays> Sensitization on GBV > There is need to have targeted interventions to religions e.g. Apostolic Sect, prophets etc.> Quality counselling must be provided at all times

THANK YOU!