Integration of tuberculosis and HIV services: Exploring the perspectives of co-infected patients in Ghana.
Scaling up of integrated tuberculosis (TB)-human immunodeficiency virus (HIV) services remains sub-optimal in many resource-limited countries, including Ghana, where the two conditions take a heavy toll on the financial resources of health systems as well as infected persons. Previous studies have documented several implementation challenges towards TB-HIV service integration, but views of patients on integrated service delivery have not received commensurate research attention. This paper explored the experiences of 40 TB-HIV co-infected patients at different stages of treatment in Ghana. Using Normalisation Process Theory as a framework, data were coded using inter-rater coding technique and analysed inductively and deductively with the help of QSR NVivo 10. For several participants, either of the diseases was diagnosed 'accidentally', leading to inconsistencies in co-therapy administration, constraints regarding separate clinic appointment dates for TB and HIV and prolonged TB treatment due to treatment failure. Put differently, there were widespread negative experiences among TB-HIV co-infected patients with regard to treatment and care, especially among patients who were accessing care in separate facilities or separate units in the same facility. Co-infected patients unanimously support full-service integration. However, they felt powerless to request for reforms on a mode of service delivery.
['Anku|Prince Justin|PJ|', 'Amo-Adjei|Joshua|J|', 'Doku|David Teye|DT|', 'Kumi-Kyereme|Akwasi|A|']
D000328:Adult D060085:Coinfection D019033:Delivery of Health Care, Integrated D005260:Female D005869:Ghana D015658:HIV Infections D006801:Humans D007407:Interviews as Topic D008297:Male D008875:Middle Aged D036301:Qualitative Research D014376:Tuberculosis
integration Tuberculosis HIV co-infected patients Ghana