Quality of Prevention of Mother to Child Transmission (PMTCT) of HIV Services in Public Hospitals of Hadiya Zone, Southern Ethiopia

Abstract

Background: Prevention of mother-to-child transmission describes a comprehensive package of services intended to reduce mother-to-child transmission of HIV. Transmission of HIV from mother to child accounts for more than 90% of pediatric Acquired Immunodeficiency Syndrome (AIDS). Few studies examining the quality of PMTCT services provision in Ethiopia are available. Therefore, this study aimed to assess the quality of PMTCT services in public hospitals of Hadiya zone, southern Ethiopia.Methods: Institution based cross-sectional study design using both quantitative and qualitative methods was conducted in public hospitals from March 1 to April 10, 2017. A total of 423 pregnant women were consecutively interviewed at three hospitals. Service provision processes were observed for 21 counseling sessions and nine in-depth interviews were conducted with health care providers, medical director and mothers' support group. Additionally, resource inventory was done. Donabedian's Structure-Process-Outcome model was used to assess the quality of PMTCT service at respective study area. Data was analyzed using SPSS 20. Binary and multivariate logistic regressions were computed. The qualitative data were analyzed manually using thematic analysis method to support quantitative result through triangulation.Result: Most of the minimum required resources such as test kits, ARV drugs and other supplies were available in hospitals studied. However, inadequate of trained human resource was observed. About 89.8% clients were satisfied with PMTCT services provided at public hospitals. The client satisfaction with PMTCT services were associated with waiting time [AOR=4.6, 95% CI; 2.18, 9.89], counseling time [AOR=3.7, 95% CI; 1.64, 8.54] and counseling given by same counselor before and after HIV test [AOR=0.2, 95% CI; 0.09, 0.41].Discussion: Although clients' satisfaction by PMTCT service is very high. Availability of necessary resource and compliance of health care providers to national guideline need improvement. More efforts to be exerted on improving providers' compliance with national PMTCT guideline, consistent supply of necessary resources to improve quality of PMTCT services.

Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study

“…This include ARV drugs (TDF+3TC+NVP), Neverapine syrup and tables, Cotrimoxazole syrup and tablets, family planning supplies, basic obstetric care supplies, client folder, patent registers and forms. On the other hand the report complies with similar evidence from [14] public hospitals of Hadiya zone of southern Ethiopia. However, with low availability coverage as reported from [13,22] of Northern Ethiopia, and Zimbabwe respectively.…”

“…For instance, 16% over all LTF was reported in North East Ethiopia with (11.9%) at 6 months, (15.7%) at 12 months and (22.6%) at 24 months respectively [11], 14.8% in Eastern Ethiopia [12],and northern Ethiopia 9.8% Axum saint marry hospital [13]. As reported from different facility based 4 studies [14,15,16], poor service quality was the main challenge. As evidenced in [10], in line with input-process quality component, some health facilities were made operational with necessary supply chain related problems, lack of service integration and poor service compliance with national technical standards.…”

“…As evidenced in [10], in line with input-process quality component, some health facilities were made operational with necessary supply chain related problems, lack of service integration and poor service compliance with national technical standards. On the other hand, inadequacy of trained human resources and compliance of health care providers with national standards as predictor factors that render service quality of Option B+ [14] Hadiya zone of southern Ethiopia. With regard to process quality component, poor counseling, room privacy, waiting time, and inadequate confidentiality were reported [15] from Dessie referral hospital of northern Ethiopia.…”

Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study

“…Similarly, 14.8% was reported from Eastern Ethiopia [12] and 9.8% from northern Ethiopia [13]. As evidenced from different facility based studies [14][15][16], poor service quality was the main challenge. For instance, an evidence from [10], relay on input-process quality items in which some health facilities were made operational with necessary supply chain related problems, lack of service integration and poor service compliance with national technical standards .…”

“…For instance, an evidence from [10], relay on input-process quality items in which some health facilities were made operational with necessary supply chain related problems, lack of service integration and poor service compliance with national technical standards . On the other hand, inadequacy of trained human resources and compliance of health care providers with national standards were documented as predictor factors that render service quality in Hadya Zone of Southern Ethiopia [14]. With regard to process quality component, poor counseling, room privacy, waiting time, and inadequate confidentiality were reported from Dessie referral hospital of northern Ethiopia [15].…”