Medical Appointment Adherence and Challenges Encountered by HIV Infected Children at Kenyatta National Hospital, Kenya

Abstract

Purpose: The goal of this study was to determine the adherence and challenges to scheduled medical appointment on HIV care services among HIV positive children aged 18 months to nine years undergoing treatment at Kenyatta National Hospital, Kenya at six months interval Methodology: The study design was prospective cohort study design consisting of 221 caregivers and their HIV infected children. Consecutive sampling method was used, in which potential participants were sought out on a daily basis until we had contacted all the eligible individuals and enroled them.This research was undertaken from March, 2017 to November, 2018. The study participants each was followed for period of one year. Pretested questionnaire was used for collecting data together with review of standardized clinical notes on challenges and adherence to scheduled medical appointments. Data was analyzed using statistical package for the Social Sciences (SPSS) Version 20. The descriptive statistics were done and data was presented in frequency tables. Ethical approval no P688/09/2016) was obtained. Findings:  It was observed that adherence to scheduled medical appointment among children infected with HIV ranged from 77% to 81.9% at 6 and 12 months respectively. This study found an average of 20% of children infected with HIV are at high risk of adverse outcomes related to non-adherence to planned medical appointments. The observed difference on adherence was associated with financial constrain, perceived stigma and discrimination, long distance and long waiting period in the medical HIV clinic. Unique Contribution to Theory, Practice and Policy: Targeted intervention aimed at addressing measures to reduce children missing attendance of scheduled medical appointment is vital. The health care providers may address measures to reduce children missing attendance of scheduled medical appointment by reducing waiting time in the clinic and reducing the number of scheduled medical appointments. This study adds to the pool of knowledge that stigma and discrimination, long waiting time in the clinic and the number of scheduled medical appointments has influence on adherence to appointments. The attendance of scheduled medical appointment should be enhanced in the policies by Ministry of health and HIV health care providers focusing on reducing waiting time, mitigating stigma and discrimination.