Assessment Of Quality Of Antenatallinked Hiv Counseling And Testing For Intervention Of Pmtct In Addis Ababa Ethiopia

Background: The most important component of PMTCT program is HIV Counseling and Testing (HCT).rnA high quality of HCT is essential for success. In Ethiopia PMTCT services began in 2003, but onlyrn0.8% of HIV infections among births to HIV positive women was averted in 2005/6 through PMTCTrnObjective: the aim of this study was to assess the quality of antenatal–linked HIV counseling andrntesting as an intervention for PMTCT at ten public Health Centers in Addis Ababa City.rnMethodology: a cross sectional study was conducted at purposively selected 10 health centers inrnAddis Ababa from April to May 2008. Methods included structured observations of counselingrnsessions, interviews of 10 PMTCT site coordinators, 9 counselors and 422 exit clients. Data on clientrnsatisfaction, counselors’ communicative skills, duration and content of pre- and post test counselingrnwas collected using a structured questionnaire adapted from UNAIDS tools. SPSS version 15.0 wasrnused to enter, clean, and analyze the data. Descriptive and analytic statistics were computed.rnResult: 6 of the 10 health centers had an HCT uptake rate of 90 to 100% of those counseled, and 8 ofrnthe health centers had a client return rate of 90% to 100% to collect the test results. A total of 66 (31rnpre- and 35 post test) counseling sessions were observed. The mean duration of pretest counselingrnwas 5.37 minutes (+3.34) and that of post test was 3.0 minutes (+ 2.24). In 25.8% of the sessions, thernmothers were not given the chance to freely consent or dissent for blood test. During the post testrnsessions, in 42.9% of the session the clients’ understanding of the meaning of their test results was notrnexplored. At exit interview, 21.3% of the clients didn’t know why they were offered HCT particularlyrnduring their pregnancy time. The odds of knowing why HCT is offered during pregnancy was higherrnamong those residents of Addis Ababa and clients who spent 5-15 min on discussion with theirrncounselors [OR = 4.48, 95% CI: 1.84, 10.9 and OR=2.1, 95%CI: 1.03, 4.24 resp.]. Generally, 89.8%rnof the clients reported being satisfied with the pre-and/or post-testing counseling discussions.rnConclusion: The communicative skill of the counselors was generally ‘satisfactory’. The majority ofrnpre- and post-test sessions included the basic information on HIV transmission/prevention andrnPMTCT. However the discussions were unusually too brief, rudimentary and lacking depth andrncoverage. Nearly a quarter of the exit clients didn’t understand why they were offered HCTrnparticularly during their pregnancy time; however, the vast majority of the women interviewed werernsatisfied with the counselling and counsellors interactions.rnKey words: PMTCT, HIV, HCT, Quality, Counselors’ skills, Satisfaction: Addis Ababa

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