Social determinants of health on human immunodeficiency virus care quality in Indonesia

Aims: The aim was to examine the social determinants of health on human immunodeficiency virus care quality for children in Indonesia. 

Design: A qualitative design using constructivist grounded theory methods was utilized. 

Methods: Data were collected between 2019 and 2020 using in-depth- interviews and memo writing. In total, 23 semi-structured individual interviews with healthcare professionals, 12 with children with human immunodeficiency virus, and eight family members were conducted. Data were analysed with the two-step initial coding and focused coding, along with the constant comparative method, theoretical sensitivity and memo writing. 

Results: Five themes were constructed from participants' perspectives on human immunodeficiency virus care for children: (1) living with a low-socioeconomic status, (2) lacking instrumental support, (3) experiencing complicated procedures for public health insurance, (4) limited Human Immunodeficiency Virus care services for children and (5) lacking care coordination, policies and practices. 

Conclusion: Children living with human immunodeficiency virus had poor health outcomes, due to having a low-socioeconomic status, reduced access to healthcare, coupled with a lack of social support services. 

Impact: This study demonstrated how the social determinants of health negatively impact the quality of care for Indonesian children with human immunodeficiency virus and their families. Understanding these determinants would benefit health professionals, in particular nurses, to consider these factors in their assessment to create a holistic care plan for children living with human immunodeficiency virus and their families. Addressing the social determinants of health would beneficially enhance outcomes and well-being of children living with human immunodeficiency virus health in Indonesia.