医療システムと政策研究

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

Bahailu Balcha Bachore, Fikru Tafese, Feyera Gebissa, Dejene Ermias Mekango

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.