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

Abstract

Background: Prevention of mother-to-child transmission is a term used to describe a comprehensive package of services intended to reduce the risk of mother-to-child transmission of HIV. The vertical virus transmission from mother to child accounts for more than 90% of pediatric Acquired Immunodeficiency Syndrome. Published studies on the quality of PMTCT services’ provision in Ethiopia are generally limited. Even fewer studies do examine quality of the services. Objective: To assess the quality of Prevention of Mother-to-Child Transmission of HIV services in public hospitals of Hadiya zone, southern Ethiopia 2017. Methods: Institution based cross-sectional study design using both quantitative and qualitative data collection method was conducted in public hospitals from March 01 to April 10, 2017. A total of 423 pregnant women were consecutively interviewed until the required sample was obtained. Service provision processes were observed for 21 counseling sessions. 9 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. The data was entered in to Epi-data and analyzed using SPSS. Bivariate and multivariable logistic regression analyses were computed to see the predictors for satisfaction of clients on PMTCT service. The qualitative data were analyzed manually using thematic analysis method and finally it was presented with quantitative result through triangulation. Result: Most of the minimum required resources such as test kits, ARV drugs and other supplies were available in the hospital. However, inadequate of trained human resource was observed. Moreover, there was repeatedly missing of some important components in the counseling manual during both pre-test and post-test counseling sessions. About 89.8% clients were satisfied with PMTCT services provided at public hospitals. The client satisfaction with PMTCT services was associated with waiting time [AOR =4.648, 95% CI = (2.183, 9.897)], counseling time [AOR =3.748, 95% CI = (1.645, 8.537)] and counseling given by same counselor before and after HIV test [AOR =0.193, 95%CI: (0.090, 0.412)]. Conclusion and Recommendation: Although clients’ satisfaction by PMTCT service is very high. Availability of necessary resource and compliance of health care providers to national guideline need improvement. We recommend more efforts to be exerted on improving providers’ compliance with national PMTCT guideline, consistent supply of necessary resources to improve quality of PMTCT services.