Abstract

This study delves into the factors influencing the utilization of pediatric antiretroviral therapy (ART) services at Buea Regional Hospital, focusing on the multifaceted challenges that caregivers and children living with HIV/AIDS face in accessing and adhering to these crucial treatments. The effective use of ART is vital for the health and survival of children living with HIV, particularly in resource-limited settings like Cameroon, where socioeconomic and healthcare barriers can significantly impact treatment outcomes.

The study employs a cross-sectional design, involving 20 caregivers of pediatric patients who are currently receiving ART at Buea Regional Hospital. Data were collected through structured questionnaires and in-depth interviews to explore a range of factors, including demographic characteristics, socio-economic status, knowledge and awareness of ART, perceived barriers to accessing ART services, and the overall quality of healthcare services provided at the hospital. The study also examines how these factors correlate with the regularity of clinic visits and adherence to ART protocols, which are critical for maintaining the health of children living with HIV.

The results indicate that multiple factors influence the utilization of pediatric ART services, often intersecting in ways that either facilitate or hinder access to care. Socio-economic status was identified as a primary determinant, with caregivers from lower-income households encountering more significant challenges in consistently accessing ART services. These challenges include the costs associated with transportation to the hospital, the ability to take time off work for clinic visits, and the financial burden of managing a chronic illness in the family. Lower-income caregivers often reported irregular clinic attendance and difficulties in adhering to prescribed ART regimens for their children, highlighting the need for economic support mechanisms to improve access.

Knowledge and awareness of ART and its benefits were generally high among caregivers. Most caregivers understood the importance of consistent ART in managing HIV and preventing the progression of the disease. However, despite this knowledge, stigma and misinformation about HIV/AIDS remain pervasive, particularly in rural areas. Some caregivers reported fear of social ostracism if their child’s HIV status were to become known, which in turn led to hesitancy in accessing ART services openly. This stigma, combined with cultural beliefs about illness and treatment, poses a significant barrier to the effective use of ART.

The quality of healthcare services at Buea Regional Hospital also plays a crucial role in determining the utilization of ART services. Caregivers frequently cited the availability of medications, the professionalism and empathy of healthcare providers, and the overall accessibility of the hospital as critical factors in their decision to bring their children for regular ART follow-ups. Positive interactions with healthcare providers, characterized by supportive and non-judgmental attitudes, were linked to higher adherence rates and more frequent clinic visits. Conversely, issues such as long waiting times, occasional stock-outs of ART medications, and logistical challenges related to reaching the hospital were identified as significant barriers. These service-related factors can deter caregivers from maintaining regular clinic visits and adhering to treatment plans, ultimately compromising the health outcomes of their children.

In addition to the above factors, the study highlights the impact of transportation challenges on ART service utilization. Many caregivers travel long distances from rural areas to reach Buea Regional Hospital, and the cost and time involved in this travel can be prohibitive. In some cases, caregivers reported missing scheduled appointments due to a lack of affordable transportation options, which underscores the need for community-based ART services or transportation subsidies to improve access.

In conclusion, the utilization of pediatric ART services at Buea Regional Hospital is influenced by a complex interplay of socio-economic, informational, and healthcare service-related factors. To improve ART uptake and adherence among children living with HIV, it is essential to address these barriers through a multi-pronged approach. This approach should include economic support for low-income families, targeted education campaigns to combat stigma and misinformation, and enhancements in healthcare service delivery, such as reducing waiting times and ensuring a consistent supply of ART medications. Additionally, expanding community-based ART services or providing transportation assistance could further improve access for caregivers and their children. By addressing these challenges, it is possible to enhance the effectiveness of ART programs and improve the overall health outcomes for pediatric HIV patients in the Buea region.

Keywords

Pediatric antiretroviral therapy, utilization factors, Buea Regional Hospital, HIV/AIDS, socio-economic barriers, healthcare service quality, caregiver knowledge, adherence, stigma, transportation challenges.