Quality of option B + prevention of mother-to-child transmission of HIV services in public hospitals of Gamo zone, Southern Ethiopia, mixed approach

Abstract

Background Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services. Methods An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian’s model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess quality in the output dimension. Finally, those hospitals that scored above 90% in each component of the Donovedian model were categorized as having good quality. Finally, twelve in-depth interviews were conducted to explore barriers to the quality of option B + PMTCT services. The qualitative data were analyzed using the thematic analysis method and finally, it was presented with the quantitative result through triangulation. Results No hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. Only one hospital out of the four hospitals met the requirements for good quality of PMTCT service in the input dimension. Regarding the process and output dimension's quality of PMTCT services, two of the hospitals met the criteria for good quality. One hospital out of the total exhibited poor performance in all three dimensions of service quality for option B + PMTCT services. Conclusion According to this study no hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. PMTCT unit performance must be continuously monitored, reviewed, and supervised. To obtain the minimum required resources primary hospitals must be supported.