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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A critical assessment of the WHO responsiveness tool: Lessons from voluntary HIV testing and counselling services in Kenya
BMC Health Services Research, Volume 9, Article 243, Year 2009
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Description
Background. Health, fair financing and responsiveness to the user's needs and expectations are seen as the essential objectives of health systems. Efforts have been made to conceptualise and measure responsiveness as a basis for evaluating the non-health aspects of health systems performance. This study assesses the applicability of the responsiveness tool developed by WHO when applied in the context of voluntary HIV counselling and testing services (VCT) at a district level in Kenya. Methods. A mixed method study was conducted employing a combination of quantitative and qualitative research methods concurrently. The questionnaire proposed by WHO was administered to 328 VCT users and 36 VCT counsellors (health providers). In addition to the questionnaire, qualitative interviews were carried out among a total of 300 participants. Observational field notes were also written. Results. A majority of the health providers and users indicated that the responsiveness elements were very important, e.g. confidentiality and autonomy were regarded by most users and health providers as very important and were also reported as being highly observed in the VCT room. However, the qualitative findings revealed other important aspects related to confidentiality, autonomy and other responsiveness elements that were not captured by the WHO tool. Striking examples were inappropriate location of the VCT centre, limited information provided, language problems, and concern about the quality of counselling. Conclusion. The results indicate that the WHO developed responsiveness elements are relevant and important in measuring the performance of voluntary HIV counselling and testing. However, the tool needs substantial revision in order to capture other important dimensions or perspectives. The findings also confirm the importance of careful assessment and recognition of locally specific aspects when conducting comparative studies on responsiveness of HIV testing services. © 2009 Njeru et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2811110/bin/1472-6963-9-243-S1.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2811110/bin/1472-6963-9-243-S2.DOC
Authors & Co-Authors
Njeru, Mercy Karimi
Kenya, Nairobi
Kenya Medical Research Institute
Norway, Bergen
Universitetet I Bergen
Blystad, Astrid
Norway, Bergen
Universitetet I Bergen
Nyamongo, Isaac K.
Kenya, Nairobi
Institute of Anthropology, Gender and African Studies
Fýlkesnes, Knut M.
Norway, Bergen
Universitetet I Bergen
Statistics
Citations: 50
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1186/1472-6963-9-243
e-ISSN:
14726963
Research Areas
Health System And Policy
Infectious Diseases
Study Approach
Qualitative
Quantitative
Study Locations
Kenya