Table 5 Environmental factors (external and health care) of ART access and adherence among OPLWH
ABM Domain | Barrier/Facilitator | Select quote | Access | Adherence |
|---|---|---|---|---|
External environment | Lack of rain and failed crops | About how life is, she mentioned that other than being disturbed by hypertension and food shortage, her life wouldn’t be bad. She told me that she gets well her HIV drugs and she adheres well. Woman on ART, aged 60–69 | ✔ | |
Health care environment Clinic factors | Waiting time | He said whenever he would come to collect the drugs, he would reach at the MRC clinic in the morning, waited for drugs through the day and received it in the evening. It would cause him to go to the stall where they sell fried cassava to spend the money he had in the pocket or sometime to spend the whole day at the clinic hungry. What bothered him was the long line/ over waiting at the clinic which made him change and start accessing drugs at Kyamulibwa heath center (Government health facility). Man on ART, aged 80-plus | ✔ | |
Provider factors | Counseling | Long time when their organization had just come, it used to come in the communities and sit with people to counsel them on what to do for example taking the medicine on time and taking it every day. Therefore if counselling is carried out on them it would help people to adhere well on the drugs. Man on ART, aged 80-plus | ✔ | |
Disregard for older patients | Just a week ago when he went to Musanya’s health center, they cared for him very well and talking to him well (without barking at him). They took his weight and informed him his weight had increased by 2 k. This gave him courage to continue taking his drugs responsibly without skipping any day. Man on ART, aged 60–69 | ✔ | ✔ | |
System Factors | Appointment times | She said that those days she used to get drugs for two months currently she gets drugs for three months. She said she has never missed to take her drugs. Woman on ART, aged 60–69 | ✔ | ✔ |
Health care environment | Cost/availability of drugs | He said that when he reaches at the health facility they weigh him and note /record his weight. He then waits for the basawo to call him to receive his drugs. He told me that he has never visited the facility and find that HIV drugs are out of stock. Man on ART, aged 50–59 | ✔ | |
Good care | Regarding if she felt she received good care, she said; ‘yes, since they gave me my drugs in plenty for 2 consecutive months, I will return to the facility to collect more drugs in October 27th. They did not talk to me in an abusive way. I took all the tablets that were still remaining including the tablets I never swallowed due to lack of food. They then gave more drugs but emphasized that I should first complete the drugs that had remained before starting the newly given.’ Woman on ART, aged 60–69 | ✔ | ✔ |