Factors affecting the quality of palliative care to patients with acquired immunodeficiency syndrome in Dar es salaam city

In response to the negative impact of HI VI AIDS pandemic on health care services in the developing world, governments have adopted the Home Based Care strategy for People living with HIVI AIDS (PL WHA). However, little is known about the quality of care given to AIDS patients in the terminal stages. This study descriptive study used a mixed method of both quantitative and qualitative designs to determine factors affecting the quality of palliative care given to AIDS patients by caregivers within communities in Dar es Salaam region in Julyl August 2008. The aim of the study was to determine patient's satisfaction with palliative care services, related factors and described the palliative care given to AIDS patients within communities. The study has shown that majority of the caregivers 74% (n=37) were female. Majority of the care givers (52%, n=26) had primary education, and fourteen individuals (28%) had formal employment as nurses. Among the eighty eight patients that received care, 59(67.1 %) were female; most of the patients had attained primary education 70(79.6%). General physical care provided as the main home based care and a third (30%) of care givers provided nutritional and general counselling. Patients with a longer duration of illness (19-24 weeks) were ten times more likely to report unsatisfactory provision of care (OR, 10.4: 1.6 - 68.6); p-value 0.01. The main problems found included inadequate supplies of essential materials, inadequate training among caregivers and informal care givers (volunteers) and unsatisfied care given to patients. From the findings care givers providing palliative care services to HIV/AIDS patients face challenges most of which is beyond their abilities to solve. Given the importance of palliative care, the study recommends the government to workout a policy stating clearly the duration of training course for all caregivers. Streamline HBC, PC services provided by community volunteers and caregivers into the comprehensive health plans may provide needed solutions to problems like salaries, transport, supplies and training, which address their needs. Access to uniform package for community volunteers regardless of where they are geographically or under which organization they are, Will motivate them and increase the quality of care to their clients