Status of ANC-linked HIV counseling and testing as an intervention for PMTCT in public health facilities in Addis Ababa: quality of HIV counseling given to pregnant women for PMTCT

Abstract

Background: A high quality of PMTCT is essential for success: done well, it will result in significant reduction in child mortality through decreased peri-natal and postnatal HIV transmission; done badly, it could lead to deaths, increased drug resistance, and poor infant feeding. Objective: the aim of this study was to assess the quality of antenatal–based HIV counseling and testing as an intervention for PMTCT at ten public Health Centers in Addis Ababa City. Methodology: a cross sectional study was conducted at purposively selected 10 health centers in Addis Ababa from April to May 2008. Methods included observations of counseling sessions, and interview of key informants at PMTCT sites. Data on counselors’ communication skills, duration and content of pre- and post test counseling was collected using a structured questionnaire adapted from UNAIDS tools. SPSS Version 15.0 was used to enter, clean, and analyze the data. Results: A total of 66 (31 pre- and 35 post test) counselling sessions were observed. The mean duration of pre-test counselling was 5.37 minutes (+3.34) and that of post test was 3.0 minutes (+ 2.24). In 78.8% of the sessions, the counsellors gave clear and simple information to mothers; in 25.8% of the sessions, the mothers were not given the chance to freely consent or dissent for blood test. In the post test sessions, 42.9% of the mothers’ understanding of the meaning of their test results was not explored. Conclusions: The communication skill of the counselors was generally ‘satisfactory’. The majority of pre- and post test sessions included the basic information on HIV and PMTCT/MTCT. However, the discussions were unusually brief, rudimentary and lacked depth and coverage.