Assessment of Quality of Voluntary HIV Counseling and Testing Services in Addis Ababa, Ethiopia
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Date
2006-07
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Addis Abeba Universty
Abstract
Background: HIV testing and counseling are entry points to HIV-related care
and prevention services, and provide opportunities for people to reduce their
risk of acquiring or transmitting HIV. Very little has been done to assess the
quality of VCT services in Addis Ababa.
Objective: A cross sectional, facility based study was conducted in February
2006 to assess the quality of VCT services in Addis Ababa.
Methodology: It used structured questionnaires adopted from standardized
UNAIDS materials. The study involved 41 different VCT sites, 65 VCT
counselors and 403 VCT clients for exit interview. Six clients per counselor for
exit interview were selected systematically. Descriptive statistics were computed
for most of the variables. A non parametric comparison was made for time
variables among the three service provider sites. SPSS version 11.0 was used to
enter, clean, and analyze the data.
Results: Only 27 (69.2%) VCT sites provide follow up counseling for HIV
positive individuals besides Pre- and Post-test counseling services. Twenty two
VCT sites have a separate counseling room with adequate space. Out of 65
counselors, 61 (93.8%) were nurses and only 20 (30.8%) were self motivated to
be one. In-service training was given for only 11(16.6%) counselors and only 24
(36.9%) attend counselors’ support group. Over 83% of the clients came self
referred and 177 (43.9%) clients chose the specific VCT site because it was
close to home. The median waiting time to see a counselor was longer in
government sites and waiting time to get test results was longer in private VCT
sites. Over 79% of the clients were generally satisfied by the service.
Conclusions: Majority of the VCT sites in Addis Ababa fulfilled the minimum
requirements recommended by the WHO. There seemed to be lack of ongoing
counseling training and support for counselors. There was a high satisfaction
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rate by the clients. However, counseling session durations were found to be less
than the recommended.
Recommendations: The regional government should take measures to enhance
quality VCT services within the already available sites and establish more free
standing sites. A strong counselors’ support group should be formed and be able
to enroll as many members as possible. Further studies should apply direct
observation of counseling sessions.
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Assessment of Quality of Voluntary HIV Counseling