Cross-sectional study on effect of civil society organizations interventions on individuals infected with HIV in Busia County Kenya

Abstract

Since the discovery of HIV in the early 1980s in Kenya, Civil Society Organizations have played a major role in its fight. The aim was to study effect of intervention on improved health, nutrition and income generation activities on individuals infected by HIV. A cross-sectional study was undertaken as a baseline with aquasi experimental study design to compare intervention and non intervention sites. Two hundred and seventeen (217) respondents out of which 69.1% were females and 30.9% males selected from four sub counties of Busia County. A structured questionnaire was administered to people infected with HIV in CSO intervention and non intervention sites. In depth interviews and Focus Group Discussions (FGDs) were performed using a guide. Structured forms guided the performance on clinical examination and anthropometry procedures. The Statistical Package for Social Scientist software was used to analyze quantitative data. Frequency distributions were calculated and visualized and Chi square test with odds ratios computed. NVIVO statistics software was used to analyze qualitative data. Audio and video recordings were transcribed verbatim, line by line coding used to manage discrete units of text, and data segments reviewed to illustrate people’s perspectives. A majority of respondents had primary level education (46.3%) and was self-employed (72.1%). HIV/AIDS awareness was high in both the non-intervention (84%) and intervention (79.8%) site, with access to information playing a major role in people’s understanding of HIV/AIDS (p<0.01). Majority of respondents (95.2%) in intervention and non-intervention (96.2%) sites had easy access to ARVs, with 48.1% sourcing drugs privately. Approximately 44.1% sourced ARVs therapy from government facilities with 30.3% from CSOs. Distance to health facilities was the main challenge for those accessing ARV drugs in intervention (22.0%) and non-intervention (39.7%) sites, (OR=2.3 (95%CI=1.2-4.5), p=0.01) was greater in the non-intervention sites. Lack of cash for transport (25% versus 27%) and weakness in the body (11% versus 16.4%) were other challenges as recorded. Most respondents (93.9%) had good ARV uptake, with 74% having reported no major health problems in the recent three months. Only 7% of respondents examined clinically had abnormal blood pressure. Mean body temperature was 36.43 degrees Celsius (std. dev. =0.734). Regarding weights classification, 13.7% of the respondents were underweight, 58.9% normal, 7.3% overweight, and 5% were obese and weights differed by gender (p<0.01) significantly. A large proportion (89.1% in intervention and 94.3% in non-intervention sites) of respondents was aware of good eating habits although they practiced poor eating patterns. In the morning, the trend was (71.9% and 62.4% in the intervention and non-intervention sites) respondents eat nothing. ‘Ugali’ (posho) and traditional vegetables was the most common type of food eaten during lunch (31.0% in intervention and 34.1% in the non-intervention site) and dinner (33.6% intervention and 25.1% in non-intervention sites). Fruits are hardly consumed by majority (42.1% and 45.3%). Provision of ARV (intervention (81.3%) and non-intervention sites (84.3%), (X²(df) =0.32(1), p=0.57) was the most common mode of support received. In focus groups discussion sessions, respondents mentioned of no direct financial benefits received from CSOs although many say they recognize what the government has done for them. In their discussion, it was revealed that CSOs initiate short term projects which do not last and when they wind up get compromise when projects end. This survey demonstrates the essential role played by implementing partners (CSOs) on improved health, nutrition and socio economic status. Influence on better access to medication, balanced diet, and economic change probably contributes to living a better and healthier life for those infected with HIV.

Afr J Health Sci. 2017; 30(2):57-76