| dc.description.abstract | Health care workers shortage is a challenge facing health systems managers worldwide.
World Health Organization estimates a projected shortfall of 10 million health workers
by 2030. The shortage results in high workload, poor performance, and undesirable
patient outcomes. Implementation of World Health Organisation's Multiple-Months-
Scripting guidelines was aimed at reducing the number of times a stable HIV patient
comes to the clinic for review from monthly to between 3 and 6 months. The broad
study objective was to establish the influence of Multiple- Months-Scripting on
healthcare worker performance in HIV outpatient clinics. The study's independent
variables were health care workers' Multiple Months Scripting guidelines awareness
and adaptation, healthcare workers capacity development on Multiple Months
Scripting, persons living with HIV' Compliance with Multiple Months Scripting
regulations and Multiple Months Scripting Commodities flow. This was a cross-
sectional study conducted in 20 public facilities in Nairobi County, Kenya. A key
informant tool and a self-administered questionnaire were applied to health facility
leadership and technical healthcare worker including doctors, nurses, pharmacists and
laboratory technologists. Collected data was entered in the SPSS, for descriptive,
bivariate, and ordinal logistic regression analysis. Results showed that out of 128
respondents, 56% were females, 92% were aged between 30-49 years, 89% had served
as healthcare workers for 6-15 years, and 53% had served in HIV outpatient clinics for
6-10 years. About 99% of the respondents were aware of and adopted Multiple Months
Scripting guidelines; however, only 94% had applied Body Mass Index as a criterion
for identifying stable persons living with HIV. About 98% of respondents indicated
they were knowledgeable of Multiple Months Scripting guidelines, but 95% agreed
they had received supportive supervision, and only 86% had received the Multiple
Months Scripting training. About 98 % of respondents said they sensitized persons
living with HIV on Multiple Months Scripting; 98% said clients on Multiple Months
Scripting adhered to non-medical and medical requirements and maintained a stable
state; however, only 93% indicated clients complied with their return dates. A total of
98% of healthcare worker agreed they informed clients on the clinic return dates;
however, 48% agreed facilities had commodities stock out within six months prior to
the study. Majority of healthcare workers' 98% agreed their performance had improved,
agreed there was a reduction in client load and reduced waiting time, and 93% agreed
they had more time with clients. Bivariate analysis revealed a significant correlation
(0.334) between Multiple Months Scripting guidelines awareness and adaptation and
healthcare worker performance and a significant and strong correlation (0.225) between
client compliance against and healthcare workers performance. However, healthcare
workers' performance had a weak correlation (-0.599) with capacity development on
Multiple Months Scripting. There was no significant correlation (0.041) with Multiple
Months Scripting commodities flow. Based on ordinal logistic regression, client
compliance to Multiple Months Scripting was the most significant influencer of
healthcare workers performance, followed by Multiple Months Scripting guidelines
awareness and adaptation and finally healthcare workers capacity development on
Multiple Months Scripting (Sig. 0.002, .011 and .014 respectively). The conclusion is
that implementation of Multiple Months Scripting guidelines resulted in improved
healthcare workers performance. It is recommended that the policymakers and HSMs
should support Multiple Months Scripting and roll it out to all outpatient clinics for
improved patient outcomes. | en_US |
