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000004940 005__ 20240523043235.0
000004940 02470 $$ahttps://doi.org/10.1371/journal.pgph.0000193$$2doi
000004940 037__ $$aTEXTUAL$$bArticle
000004940 041__ $$aeng
000004940 245__ $$aOlder persons experiences of healthcare in rural Burkina Faso: Results of a cross sectional household survey
000004940 269__ $$a2022-06-09
000004940 336__ $$aArticle
000004940 520__ $$aEnsuring responsive healthcare which meets patient expectations and generates trust is important to increase rates of access and retention. This need is important for aging populations where non-communicable diseases (NCDs) are a growing cause of morbidity and mortality. We performed a cross-sectional household survey including socio-demographic; morbidities; and patient-reported health system utilization, responsiveness, and quality outcomes in individuals 40 and older in northwestern Burkina Faso. We describe results and use exploratory factor analysis to derive a contextually appropriate grouping of health system responsiveness (HSR) variables. We used linear or logistic regression to explore associations between socio-demographics, morbidities, and the grouped-variable, then between these variables and health system quality outcomes. Of 2,639 eligible respondents, 26.8% had least one NCD, 56.3% were frail or pre-frail and 23.9% had a recent healthcare visit, including only 1/3 of those with an NCD. Highest ratings of care experience (excellent/very good) included ease of following instructions (86.1%) and trust in provider skills (81.1%). The HSR grouping with the greatest factor loading included involvement in decision-making, clarity in communication, trust in the provider, and confidence in providers’ skills, labelled Shared Understanding and Decision Making (SUDM). In multivariable analysis, higher quality of life (OR 1.02,95%CI 1.01–1.04), frailty (OR 1.47,95%CI 1.00–2.16), and SUDM (OR 1.06,95%CI 1.05–1.09) were associated with greater health system trust and confidence. SUDM was associated with overall positive assessment of the healthcare system (OR 1.02,95%CI 1.01–1.03) and met healthcare needs (OR 1.09,95%CI 1.08–1.11). Younger age and highest wealth quintile were also associated with higher met needs. Recent healthcare access was low for people with existing NCDs, and SUDM was the most consistent factor associated with higher health system quality outcomes. Results highlight the need to increase continuity of care for aging populations with NCDs and explore strengthening SUDM to achieve this goal.
000004940 536__ $$oAlexander von Humboldt Foundation
000004940 536__ $$oWellcome Trust and Royal Society$$c210479/Z/18/Z
000004940 540__ $$a<p>© 2022 Goldberg et al.</p> <p>This is an open access article distributed under the terms of the <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">Creative Commons Attribution License</a>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</p>
000004940 542__ $$fCC BY
000004940 591__ $$aData are available on reasonable request with the point of contact and not publicly posted at this time to reflect equity in use prioritizing the team in Burkina Faso and collaborators to complete analyses and publications underway. In addition, for privacy issues, as noted, Data are not publicly available as consent was not given by participants for data to be shared openly. This is in part because entire age cohorts of some villages are included in the dataset, potentially allowing for deductive disclosure with sufficient local information. For this reason, anonymised data are available from CHAS study data controllers only following signature of a data use agreement restricting onward transmission. Anyone wishing to replicate the analyses presented, or conduct further collaborative analyses using CHAS (which are welcomed and considered based on a letter of intent), should contact <a href="mailto:Barteit@uni-heidelberg.de" target="_blank">Sandra Barteit</a> in the first instance.
000004940 690__ $$aPritzker School of Medicine
000004940 7001_ $$1https://orcid.org/0000-0003-1460-4940$$2ORCID$$aGoldberg, Ellen M.$$uUniversity of Chicago
000004940 7001_ $$1https://orcid.org/0000-0001-5010-1617$$2ORCID$$aBountogo, Mamadou$$u Centre de Recherche en Santé de Nouna
000004940 7001_ $$1https://orcid.org/0000-0001-6604-491X$$2ORCID$$aHarling, Guy$$uUniversity College London
000004940 7001_ $$1https://orcid.org/0000-0002-4182-4212$$2ORCID$$aBaernighausen, Till$$uUniversity of Heidelberg
000004940 7001_ $$1https://orcid.org/0000-0001-6834-1838$$2ORCID$$aDavies, Justine I.$$uUniversity of Birmingham
000004940 7001_ $$1https://orcid.org/0000-0002-4355-7437$$2ORCID$$aHirschhorn, Lisa R.$$uNorthwestern University
000004940 773__ $$tPLOS Global Public Health
000004940 8564_ $$yArticle$$9a3ee5247-feb7-40bc-8084-dcb1ba2f0d26$$s488423$$uhttps://knowledge.uchicago.edu/record/4940/files/Older-persons-experiences-of-healthcare-in-rural-Burkina-Faso.pdf$$ePublic
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000004940 908__ $$aI agree
000004940 909CO $$ooai:uchicago.tind.io:4940$$pGLOBAL_SET
000004940 983__ $$aArticle