Barriers to Access to Modern Contraception.
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Date
1988-02
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Addis Abeba Universty
Abstract
Background: Sub-Saharan Africa in which Ethiopia is a part remains the most seriously affected region with AIDS in the year 2007. More than 60% of all new HIV infections are occurring in women, infants, and young children in this region. . In 2005 alone, an estimated 540,000 children were newly infected with HIV, with approximately 90% of these infections occurring in this region.
Objective: To assess quality of PMTCT services and client satisfaction in private and public health facilities in Adama city, Oromia Region.
Methodology: A facility based cross-sectional study which involved quantitative and qualitative approach was conducted from September 2008 to June 2009. It involved 423pregnant women and 31 health providers.In 2005
Results: From all pregnant women interviewed, 74.7% of them were found to be fullysatisfied with the PMTCT service they received. Only 39% of the clients understood thecounseling on MTCT and PMTCT. Not more than 90% of the pregnant women were counseled and accepted HIV testing and partners of 6.34% of the pregnant women weretested for HIV. The average duration of stay of clients with their health care provider was12.8 minutes where the standard is 15 minutes. The average clients' waiting time was41.5 minutes and 21.5 minutes in private health facilities and governmental healthfacilities respectively. From women of reproductive age group who were infected withthe virus, 18% of them were counseled on family planning and started to use familyplanning. About 97% of the HEIs had received ARV prophylaxis. Cotrimoxazoleprophylaxis was started at two months of age for 87.4% of the HEIs. More than half(60%) of the pregnant women came to the center they visited after being recommended tocome by their friends or partners. Clients gave more weight to the ethical approach ofproviders to express their degree of satisfaction. Only two third of the health providerswho are directly involved in PMTCT services received training on VCT for PMTCT.From the providers’ side the most eminent problems were lack of training to updatealone, anthemselves with current knowledge/skills, lack of feedback on job performance and lackof incentive for the additional burden added to them. The national PMTCT guideline wasavailable and in use in only two among the eight health facilities assessed.
Conclusion: About two third (74.7%) of the clients were fully satisfied with the PMTCTservice they received. Little more than half (52%) of pregnant women were counseled onMTCT and PMTCT. Less stay of health providers with the clients, long waiting time ofclients, unavailability of advanced medical equipments and laboratory tests, lack ofconformation to the national PMTCT guideline, and poor infrastructure were the mostsignificant factors which compromised the quality of PMTCT services. Lack of familyplanning service provision together with HIV/AIDS services and lack of maleinvolvement in PMTCT services were also among the factors which compromised theachievement of the PMTCT program.
Recommendation: Offering counseling on MTCT and PMTCT to all pregnant women, todeliver quality and comprehensive PMTCT interventions by reducing clients’ waitingtime as much as possible, enabling women to communicate with their partners about HIVtesting, offering strong supportive supervision to health facilities and capacity building,and creating a strong link between HIV/AIDS and reproductive health services are crucialto improve the quality of PMTCT services.estimated 540,000 children were newly infected with HIV, with approximately 90% ofthese infections occurring in this region.
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Modern Contraception