Quality of prevention of mother-to-child transmission of HIV services in Soroti District, Uganda

Abstract

Abstract Introduction: Pregnant and breastfeeding women living with HIV have a high risk of transmitting HIV to their babies during pregnancy, labor/delivery, and postpartum through breastfeeding. With the provision of specific PMTCT services like HIV counseling and testing (HCT), early provision of ART to HIV positive pregnant and breastfeeding women and ARV prophylaxis to HIV exposed infants and infant feeding counseling, the risk of MTCT is estimated to reduce to less than 2% in non-breastfeeding populations and less than 5% in breastfeeding populations. Objective: To assess the quality of prevention of mother-to-child transmission of HIV services at government health facilities in Soroti district to inform quality improvement programs. Methods: This was a descriptive cross-sectional study using quantitative data collection methods conducted at 17 government health facilities in Soroti district which were selected both purposively and randomly. Data was collected using assessment tool developed by family health international institute for assessing quality of PMTCT services. Data collected were entered to a pre-designed data screen on access and thereafter exported to excel for cleaning. The cleaned data was imported to STATA 12.0 for descriptive analysis to generate frequencies, percentages and graphs. Composite measure analysis was performed to measure the quality of PMTCT services. Results: Seventeen (17) government health facilities were assessed, majority (76%) were rural. Health workers providing PMTCT services were mainly midwives and nurses (60%). The health workers providing PMTCT services were all trained in PMTCT service areas. PMTCT guidelines were not readily available at the health facilities. The quality of PMTCT services provided to pregnant and breastfeeding women and their infants was low (53%) at health center II facilities, high (81%) at HCIII facilities, and (73%) at both HCV facilities and the regional referral hospital. Quality of PMTCT services was also low (66%) at the rural health facilities, high (82%) at semi-urban facilities and (73%) at urban health facilities. Overall the quality of PMTCT services was low (68%) at the health facilities that were studied. Conclusion: On average, the overall quality of PMTCT of HIV services offered to pregnant and breastfeeding women and their infants at the government health facilities studied is poor. But then in other spheres, the quality of PMTCT services was good at higher level health facilities, semi-urban and urban health facilities. To improve the quality of PMTCT services provided to pregnant women, breastfeeding women and their infants at the government health facilities, there is need for the district health management and PMTCT focal personnel to ensure availability and use of PMTCT guidelines and sufficient supplies of recommended PMTCT commodities at all health facility levels in the district.