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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Preferences of Pregnant and Postpartum Women for Differentiated Service Delivery in Kenya
Journal of Acquired Immune Deficiency Syndromes, Volume 94, No. 5, Year 2023
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Description
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. © 2023 Lippincott Williams and Wilkins. All rights reserved.
Authors & Co-Authors
Humphrey, John M.
United States, Indianapolis
Indiana University School of Medicine
Carlucci, James G.
United States, Indianapolis
Indiana University School of Medicine
Naanyu, Violet
Kenya, Eldoret
Moi University
Kenya, Eldoret
Academic Model Providing Access to Healthcare
Were, Edwin O.
Kenya, Eldoret
Moi University
Alera, Marsha
Kenya, Eldoret
Academic Model Providing Access to Healthcare
Nyandiko, Winstone Mokaya
Kenya, Eldoret
Moi University
Songok, Julia Jerono
Kenya, Eldoret
Academic Model Providing Access to Healthcare
Kenya, Eldoret
Moi University
Wools-Kaloustian, Kara K.
United States, Indianapolis
Indiana University School of Medicine
Zimet, Gregory D.
United States, Indianapolis
Indiana University School of Medicine
Statistics
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0000000000003303
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Kenya
Participants Gender
Female