Assessment Of Overall Quality Of Prevention Of Mother-to-child Transmission Of Hiv Service In Adama Town Oromia Region

Background: Sub-Saharan Africa in which Ethiopia is a part remains the most seriouslyrnaffected region with AIDS in the year 2007. More than 60% of all new HIV infectionsrnare occurring in women, infants, and young children in this region. In 2005 alone, anrnestimated 540,000 children were newly infected with HIV, with approximately 90% ofrnthese infections occurring in this region.rnObjective: To assess quality of PMTCT services and client satisfaction in private andrnpublic health facilities in Adama city, Oromia Region.rnMethodology: A facility based cross-sectional study which involved quantitative andrnqualitative approach was conducted from September 2008 to June 2009. It involved 423rnpregnant women and 31 health providers.rnResults: From all pregnant women interviewed, 74.7% of them were found to be fullyrnsatisfied with the PMTCT service they received. Only 39% of the clients understood therncounseling on MTCT and PMTCT. Not more than 90% of the pregnant women wererncounseled and accepted HIV testing and partners of 6.34% of the pregnant women wererntested for HIV. The average duration of stay of clients with their health care provider wasrn12.8 minutes where the standard is 15 minutes. The average clients' waiting time wasrn41.5 minutes and 21.5 minutes in private health facilities and governmental healthrnfacilities respectively. From women of reproductive age group who were infected withrnthe virus, 18% of them were counseled on family planning and started to use familyrnplanning. About 97% of the HEIs had received ARV prophylaxis. Cotrimoxazolernprophylaxis was started at two months of age for 87.4% of the HEIs. More than halfrn(60%) of the pregnant women came to the center they visited after being recommended torncome by their friends or partners. Clients gave more weight to the ethical approach ofrnproviders to express their degree of satisfaction. Only two third of the health providersrnwho are directly involved in PMTCT services received training on VCT for PMTCT.rnFrom the providers’ side the most eminent problems were lack of training to updaternPDF Creator - PDF4Free v2.0 http://www.pdf4free.comrnviiirnthemselves with current knowledge/skills, lack of feedback on job performance and lackrnof incentive for the additional burden added to them. The national PMTCT guideline wasrnavailable and in use in only two among the eight health facilities assessed.rnConclusion: About two third (74.7%) of the clients were fully satisfied with the PMTCTrnservice they received. Little more than half (52%) of pregnant women were counseled onrnMTCT and PMTCT. Less stay of health providers with the clients, long waiting time ofrnclients, unavailability of advanced medical equipments and laboratory tests, lack ofrnconformation to the national PMTCT guideline, and poor infrastructure were the mostrnsignificant factors which compromised the quality of PMTCT services. Lack of familyrnplanning service provision together with HIV/AIDS services and lack of malerninvolvement in PMTCT services were also among the factors which compromised thernachievement of the PMTCT program.rnRecommendation: Offering counseling on MTCT and PMTCT to all pregnant women, torndeliver quality and comprehensive PMTCT interventions by reducing clients’ waitingrntime as much as possible, enabling women to communicate with their partners about HIVrntesting, offering strong supportive supervision to health facilities and capacity building,rnand creating a strong link between HIV/AIDS and reproductive health services are crucialrnto improve the quality of PMTCT services.

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