@article{123c3902dafe425da92e1f225cec94a5,
title = "Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya",
abstract = "The burden on health systems due to increased volume of patients with HIV continues to rapidly increase. The goal of this study was to examine the experiences of HIV care providers in a high patient volume HIV treatment and care program in eastern Africa. Sixty care providers within the Academic Model Providing Access to Healthcare program in western Kenya were recruited into this qualitative study. We conducted in-depth interviews focused on providers{\textquoteright} perspectives on health system factors that impact patient engagement in HIV care. Results from thematic analysis demonstrated that providers perceive a work environment that constrained their ability to deliver high-quality HIV care and encouraged negative patient–provider relationships. Providers described their roles as high strain, low control, and low support. Health system strengthening must include efforts to improve the working environment and easing burden of care providers tasked with delivering antiretroviral therapy to increasing numbers of patients in resource-constrained settings.",
keywords = "HIV care, health providers, health systems, qualitative research, sub-Saharan Africa",
author = "Becky Genberg and Juddy Wachira and Catherine Kafu and Ira Wilson and Beatrice Koech and Regina Kamene and Jacqueline Akinyi and Jennifer Knight and Paula Braitstein and Norma Ware",
note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the National Institute of Mental Health (K01MH099966). This work was facilitated by the Providence/Boston Center for AIDS Research (P30AI042853). Our research was further supported in part by a grant to the USAID-AMPATH Partnership from the United States Agency for International Development as part of the President{\textquoteright}s Emergency Plan for AIDS Relief (PEPFAR). The USAID-AMPATH Partnership is grateful for the support of the United States Agency for International Development (USAID). The contents of this study are the sole responsibility of AMPATH and do not necessarily reflect the views of USAID, NIMH, or the United States Government. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the National Institute of Mental Health (K01MH099966). This work was facilitated by the Providence/Boston Center for AIDS Research (P30AI042853). Our research was further supported in part by a grant to the USAID-AMPATH Partnership from the United States Agency for International Development as part of the President?s Emergency Plan for AIDS Relief (PEPFAR). The USAID-AMPATH Partnership is grateful for the support of the United States Agency for International Development (USAID). The contents of this study are the sole responsibility of AMPATH and do not necessarily reflect the views of USAID, NIMH, or the United States Government. Publisher Copyright: {\textcopyright} The Author(s) 2019.",
year = "2019",
month = jan,
day = "23",
doi = "10.1177/2325958218823285",
language = "English (US)",
volume = "18",
journal = "Journal of the International Association of Providers of AIDS Care",
issn = "2325-9574",
publisher = "SAGE Publications Inc.",
}