Preferences of Pregnant and Postpartum Women for Differentiated Service Delivery in Kenya
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc..
BACKGROUND: Differentiated service delivery models are implemented by HIV care programs globally, but models for pregnant and postpartum women living with HIV (PPWH) are lacking. We conducted a discrete choice experiment to determine women's preferences for differentiated service delivery.
SETTING: Five public health facilities in western Kenya.
METHODS: PPWH were enrolled from April to December 2022 and asked to choose between pairs of hypothetical clinics that differed across 5 attributes: clinic visit frequency during pregnancy (monthly vs. every 2 months), postpartum visit frequency (monthly vs. only with routine infant immunizations), seeing a mentor mother (each visit vs. as needed), seeing a clinician (each visit vs. as needed), and basic consultation cost (0, 50, or 100 Kenya Shillings [KSh]). We used multinomial logit modeling to determine the relative effects (β) of each attribute on clinic choice.
RESULTS: Among 250 PPWH (median age 31 years, 42% pregnant, 58% postpartum, 20% with a gap in care), preferences were for pregnancy visits every 2 months (β = 0.15), postpartum visits with infant immunizations (β = 0.36), seeing a mentor mother and clinician each visit (β = 0.05 and 0.08, respectively), and 0 KSh cost (β = 0.39). Preferences were similar when stratified by age, pregnancy, and retention status. At the same cost, predicted market choice for a clinic model with fewer pregnant/postpartum visits was 75% versus 25% for the standard of care (ie, monthly visits during pregnancy/postpartum).
CONCLUSION: PPWH prefer fewer clinic visits than currently provided within the standard of care in Kenya, supporting the need for implementation of differentiated service delivery for this population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:94 |
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| Enthalten in: |
Journal of acquired immune deficiency syndromes (1999) - 94(2023), 5 vom: 15. Dez., Seite 429-436 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Humphrey, John [VerfasserIn] |
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| Anmerkungen: |
Date Completed 13.11.2023 Date Revised 10.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/QAI.0000000000003303 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364411104 |
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| 245 | 1 | 0 | |a Preferences of Pregnant and Postpartum Women for Differentiated Service Delivery in Kenya |
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| 500 | |a Date Revised 10.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. | ||
| 520 | |a BACKGROUND: Differentiated service delivery models are implemented by HIV care programs globally, but models for pregnant and postpartum women living with HIV (PPWH) are lacking. We conducted a discrete choice experiment to determine women's preferences for differentiated service delivery | ||
| 520 | |a SETTING: Five public health facilities in western Kenya | ||
| 520 | |a METHODS: PPWH were enrolled from April to December 2022 and asked to choose between pairs of hypothetical clinics that differed across 5 attributes: clinic visit frequency during pregnancy (monthly vs. every 2 months), postpartum visit frequency (monthly vs. only with routine infant immunizations), seeing a mentor mother (each visit vs. as needed), seeing a clinician (each visit vs. as needed), and basic consultation cost (0, 50, or 100 Kenya Shillings [KSh]). We used multinomial logit modeling to determine the relative effects (β) of each attribute on clinic choice | ||
| 520 | |a RESULTS: Among 250 PPWH (median age 31 years, 42% pregnant, 58% postpartum, 20% with a gap in care), preferences were for pregnancy visits every 2 months (β = 0.15), postpartum visits with infant immunizations (β = 0.36), seeing a mentor mother and clinician each visit (β = 0.05 and 0.08, respectively), and 0 KSh cost (β = 0.39). Preferences were similar when stratified by age, pregnancy, and retention status. At the same cost, predicted market choice for a clinic model with fewer pregnant/postpartum visits was 75% versus 25% for the standard of care (ie, monthly visits during pregnancy/postpartum) | ||
| 520 | |a CONCLUSION: PPWH prefer fewer clinic visits than currently provided within the standard of care in Kenya, supporting the need for implementation of differentiated service delivery for this population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 700 | 1 | |a Wanjama, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Carlucci, James G |e verfasserin |4 aut | |
| 700 | 1 | |a Naanyu, Violet |e verfasserin |4 aut | |
| 700 | 1 | |a Were, Edwin |e verfasserin |4 aut | |
| 700 | 1 | |a Muli, Lindah |e verfasserin |4 aut | |
| 700 | 1 | |a Alera, Marsha |e verfasserin |4 aut | |
| 700 | 1 | |a McGuire, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Nyandiko, Winstone |e verfasserin |4 aut | |
| 700 | 1 | |a Songok, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Wools-Kaloustian, Kara |e verfasserin |4 aut | |
| 700 | 1 | |a Zimet, Gregory |e verfasserin |4 aut | |
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