Health system factors associated with clinic appointment-keeping among children under five years of age at the outpatient care department of the Entebbe Regional Referral Hospital nutrition unit. A cross-sectional study.
DOI:
https://doi.org/10.51168/dffbc207Keywords:
Clinic appointment-keeping, health system factors, severe acute malnutrition, outpatient nutrition care, children under fiveAbstract
Background:
The study aimed to determine the health system factors associated with clinic appointment-keeping among children under five years of age at the outpatient care department of the ERRH Nutrition Unit.
Methodology:
A quantitative descriptive cross-sectional study was conducted among caregivers of children under five years receiving outpatient severe acute malnutrition care at the ERRH Nutrition Unit. From a study population of 240, a sample of 144 participants was selected purposively. Primary data were collected using self-administered, closed-ended questionnaires with a five-point Likert scale. Data were coded and analyzed using SPSS through descriptive, correlation, and regression analyses at a 5% significance level. Validity was ensured through supervisor review, while reliability was assessed using test-retest. Ethical approval and informed consent were obtained.
Results:
A total of 103 of 140 questionnaires were returned, giving a 73.5% response rate. Females constituted 72.8% (75) of respondents, while males accounted for 27.2% (28). Most respondents, 74.8% (77), reported having missed a clinic appointment, compared with 25.2% (26) who had not. Pearson correlation analysis demonstrated a weak, positive, significant relationship between health system factors and clinic appointment-keeping (r=0.271, p<0.001, n=103). Bivariate regression analysis showed that health system factors explained 7.4% of the variation in clinic appointment-keeping (R²=0.074; adjusted R²=0.069; SE=0.60450). The regression model was statistically significant (F=16.070, p<0.001). Health system factors significantly predicted appointment-keeping (B=0.335, SE=0.084, β=0.271, t=4.009, p<0.001), indicating a positive association. The constant was also statistically significant (B=2.296, SE=0.332, t=6.920, p<0.001).
Conclusion:
Health system factors significantly influenced appointment-keeping, particularly waiting time, appointment scheduling, patient-health worker communication, and transport accessibility.
Recommendation:
Appointment scheduling systems should be optimized with clear reminders, such as SMS notifications.
References
1. Kalyango, J. N., Hall, M., & Karamagi, C. (2014). Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda. Pan African Medical Journal, 19, Article 229. https://doi.org/10.11604/pamj.2014.19.229.3971
2. Nakate, M. G., Omech, B., Kwagala, C., Gimbo, I., Bulitya, A., Kyeswa, J., Katwere, E., Kabunga, A., & Udho, S. (2023). Factors influencing the status of adherence to the second clinic visit among clients newly diagnosed with HIV in Northern Uganda: A mixed-methods study. HIV/AIDS - Research and Palliative Care, 15, 135–143. https://doi.org/10.2147/HIV.S405492
3. Oliveira, E. F., de Camargo, C. L., Gomes, N. P., Couto, T. M., Campos, L. M., & Oliveira, P. S. (2019). Factors related to quilombola attendance at child follow-up appointments. Revista Brasileira de Enfermagem, 72(Suppl. 3), 9–16. https://doi.org/10.1590/0034-7167-2017-0605
4. Puett, C., & Guerrero, S. (2015). Barriers to access for severe acute malnutrition treatment services in Pakistan and Ethiopia: A comparative qualitative analysis. Public Health Nutrition, 18(10), 1873–1882. https://doi.org/10.1017/S1368980014002444
5. Sun, C.-A., Taylor, K., Levin, S., Renda, S. M., & Han, H.-R. (2021). Factors associated with missed appointments by adults with type 2 diabetes mellitus: A systematic review. BMJ Open Diabetes Research & Care, 9(1), e001819. https://doi.org/10.1136/bmjdrc-2020-001819
6. Thomas, T. K. (2017). Factors affecting mental health clinic attendance in Sheema District, South Western Uganda [Master’s dissertation, Kampala International University]. Kampala International University Institutional Repository.
