Assessment of Quality of Antenatal–Linked HIV Counseling and Testing for Intervention of PMTCT in Addis Ababa, Ethiopia

No Thumbnail Available



Journal Title

Journal ISSN

Volume Title


Addis Ababa University


Background: The most important component of PMTCT program is HIV Counseling and Testing (HCT). A high quality of HCT is essential for success. In Ethiopia PMTCT services began in 2003, but only 0.8% of HIV infections among births to HIV positive women was averted in 2005/6 through PMTCT Objective: the aim of this study was to assess the quality of antenatal–linked 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 structured observations of counseling sessions, interviews of 10 PMTCT site coordinators, 9 counselors and 422 exit clients. Data on client satisfaction, counselors’ communicative 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. Descriptive and analytic statistics were computed. Result: 6 of the 10 health centers had an HCT uptake rate of 90 to 100% of those counseled, and 8 of the health centers had a client return rate of 90% to 100% to collect the test results. A total of 66 (31 pre- and 35 post test) counseling sessions were observed. The mean duration of pretest counseling was 5.37 minutes (+3.34) and that of post test was 3.0 minutes (+ 2.24). In 25.8% of the sessions, the mothers were not given the chance to freely consent or dissent for blood test. During the post test sessions, in 42.9% of the session the clients’ understanding of the meaning of their test results was not explored. At exit interview, 21.3% of the clients didn’t know why they were offered HCT particularly during their pregnancy time. The odds of knowing why HCT is offered during pregnancy was higher among those residents of Addis Ababa and clients who spent 5-15 min on discussion with their counselors [OR = 4.48, 95% CI: 1.84, 10.9 and OR=2.1, 95%CI: 1.03, 4.24 resp.]. Generally, 89.8% of the clients reported being satisfied with the pre-and/or post-testing counseling discussions. Conclusion: The communicative skill of the counselors was generally ‘satisfactory’. The majority of pre- and post-test sessions included the basic information on HIV transmission/prevention and PMTCT. However the discussions were unusually too brief, rudimentary and lacking depth and coverage. Nearly a quarter of the exit clients didn’t understand why they were offered HCT particularly during their pregnancy time; however, the vast majority of the women interviewed were satisfied with the counselling and counsellors interactions. Key words: PMTCT, HIV, HCT, Quality, Counselors’ skills, Satisfaction: Addis Ababa



PMTCT, HIV, HCT, Quality, Counselors’ skills, Satisfaction: Addis Ababa