Using verbal and social autopsies to explore health-seeking behaviour among HIV-positive women in Kenya: a retrospective study

BMC Women's Health

Research Article

Rebecca Njuki¹  James Kimani²  Charlotte Warren²  Francis Obare² 

[1] Center for Population Health Research Management, Magharibi Place, P.O. Box 19607–00202, 2nd Floor, Room 2, Nairobi, Kenya;Population Council, General Accident Insurance House, P.O. Box 17643–00500, Ralph Bunche Road, Nairobi, Kenya;

关键词: Verbal and social autopsy;    HIV;    Health care seeking behaviour;    Women;    Kenya;   

DOI  :  10.1186/1472-6874-14-77

 received in 2013-04-03, accepted in 2014-06-20,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThere is limited understanding of the factors that influence decisions to seek HIV care and treatment services in community settings. The aim of this study was to explore the socio-cultural and health system factors affecting health-seeking behaviour among deceased women in Kenya who were living with HIV at the time of death.MethodsOut of a total of 796 deaths for which a caregiver was available to provide information, retrospective data were drawn from verbal and social autopsies administered to caregivers of 218 women who had died of AIDS-related illnesses aged 15 to 49 years. Information was collected on essential elements of the care-seeking process from the onset of severe illness episodes and analysed using qualitative and quantitative techniques.ResultsResults from the quantitative data showed that poor women were less likely to access formal health services (OR = 0.2; p < 0.001) compared to non-poor women. The qualitative data showed that socioeconomic status, poor knowledge and understanding of AIDS-related illness, distance to facility and transportation costs, medical pluralism, stigma, low HIV risk perception, lack of family support and health care system barriers contributed to delays/constraints in seeking care.ConclusionsThe findings highlight important issues that have implications for addressing challenges faced by women living with HIV, including non-adherence to treatment regimen and late diagnosis of HIV. Provision of transportation subsidies as part of the national social safety-net strategy can help in addressing financial constraints associated with transportation costs among poor women living with HIV.

【 授权许可】

CC BY   
© Njuki et al.; licensee BioMed Central Ltd. 2014