Abstract

Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015: Background: Penda Health is a chain of private, for-profit outpatient clinics that delivers comprehensive primary care to low and middle income Kenyans using midlevel care providers (certified nurse practitioners and clinical officers), caring for approximately 2,000 patients per month. Penda's aim is to provide high quality, low cost services, and empathetic and caring healthcare to patients through innovative standardized protocols, qualified right-skilled providers 1, and strong supplier partnerships. 2 In low and middle-income settings, healthcare provider adherence to guidelines has shown mixed results - with many studies showing public sectors having more adherence to guidelines 3; however, after implementing organizational and educational interventions, Penda has nearly doubled adherence rates surrounding four diagnoses although adherence rates varied significantly per diagnosis (urinary tract infection, vaginal discharge, tonsillitis, and childhood diarrhea). 4 Adherence to guidelines has been shown to be lower in private sector healthcare systems in low and middle income countries, although Penda has show great success in improving adherence rates through targeted interventions. 3 Specifically in childhood diarrhea, both in public and private clinics dehydration guideline adherence ranged between 0% and 84% across 23 countries with a median of 20% correct treatment. 5 Penda has goals of scaling and replicating quickly in Kenya and has had a focus on provider guideline adherence. However, as an organization, it is still working to identify core components that enhance provider adherence and operationalize a systematized provider development plan. Thus, gaining leadership understanding of provider barriers and facilitators to guideline adherence will aid in understanding and developing a systemized provider development plan in the future. Purpose: To gain an understanding of organizational leadership understanding of healthcare providers' barriers and facilitators in guideline adherence in order to develop interventions to retain healthcare providers. Setting: Penda Health clinics surrounding Nairobi, Kenya in East Africa. Methods: In May and June 2015 we will conduct contextual qualitative interviews with Penda organizational leadership (N=3). This will allow for further interpretation of quantitative data based on healthcare providers' adherence to guidelines related to urinary tract infections, vaginal discharge, childhood diarrhea, and tonsillitis. Findings: We believe a comprehensive understanding of healthcare provider rationale for guideline adherence will benefit Penda in their future scaling and replication plans to open 100 clinics by 2020 across East Africa, seeing over 2 million patients per year. 2 Barriers and facilitators to guideline adherence will allow for creation of low-cost, high-impact organization level interventions to improve healthcare provider adherence now, as well as during Penda's rapid scale-up. Not only will Penda be able to increase consistent healthcare provider guideline adherence between all providers and sites, but they may also improve patient safety and quality of care due to improved provider guideline adherence quality improvement and evaluation projects.

Description

43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`

Author Details

Brittney J. Sullivan, RN, CPNP

Sigma Membership

Beta Epsilon

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Global Health, Guideline Adherence

Conference Name

43rd Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Las Vegas, Nevada, USA

Conference Year

2015

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Acquisition

Proxy-submission

Download

Share

COinS
 

Guideline Adherence among Kenyan Healthcare Providers in Peri-Urban For-Profit Clinic

Las Vegas, Nevada, USA

Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015: Background: Penda Health is a chain of private, for-profit outpatient clinics that delivers comprehensive primary care to low and middle income Kenyans using midlevel care providers (certified nurse practitioners and clinical officers), caring for approximately 2,000 patients per month. Penda's aim is to provide high quality, low cost services, and empathetic and caring healthcare to patients through innovative standardized protocols, qualified right-skilled providers 1, and strong supplier partnerships. 2 In low and middle-income settings, healthcare provider adherence to guidelines has shown mixed results - with many studies showing public sectors having more adherence to guidelines 3; however, after implementing organizational and educational interventions, Penda has nearly doubled adherence rates surrounding four diagnoses although adherence rates varied significantly per diagnosis (urinary tract infection, vaginal discharge, tonsillitis, and childhood diarrhea). 4 Adherence to guidelines has been shown to be lower in private sector healthcare systems in low and middle income countries, although Penda has show great success in improving adherence rates through targeted interventions. 3 Specifically in childhood diarrhea, both in public and private clinics dehydration guideline adherence ranged between 0% and 84% across 23 countries with a median of 20% correct treatment. 5 Penda has goals of scaling and replicating quickly in Kenya and has had a focus on provider guideline adherence. However, as an organization, it is still working to identify core components that enhance provider adherence and operationalize a systematized provider development plan. Thus, gaining leadership understanding of provider barriers and facilitators to guideline adherence will aid in understanding and developing a systemized provider development plan in the future. Purpose: To gain an understanding of organizational leadership understanding of healthcare providers' barriers and facilitators in guideline adherence in order to develop interventions to retain healthcare providers. Setting: Penda Health clinics surrounding Nairobi, Kenya in East Africa. Methods: In May and June 2015 we will conduct contextual qualitative interviews with Penda organizational leadership (N=3). This will allow for further interpretation of quantitative data based on healthcare providers' adherence to guidelines related to urinary tract infections, vaginal discharge, childhood diarrhea, and tonsillitis. Findings: We believe a comprehensive understanding of healthcare provider rationale for guideline adherence will benefit Penda in their future scaling and replication plans to open 100 clinics by 2020 across East Africa, seeing over 2 million patients per year. 2 Barriers and facilitators to guideline adherence will allow for creation of low-cost, high-impact organization level interventions to improve healthcare provider adherence now, as well as during Penda's rapid scale-up. Not only will Penda be able to increase consistent healthcare provider guideline adherence between all providers and sites, but they may also improve patient safety and quality of care due to improved provider guideline adherence quality improvement and evaluation projects.