Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study

 

Show simple item record

dc.contributor.author Ekouevi, Didier K en_ZA
dc.contributor.author Stringer, Elizabeth en_ZA
dc.contributor.author Coetzee, David en_ZA
dc.contributor.author Tih, Pius en_ZA
dc.contributor.author Creek, Tracy en_ZA
dc.contributor.author Stinson, Kathryn en_ZA
dc.contributor.author Westfall, Andrew O en_ZA
dc.contributor.author Welty, Thomas en_ZA
dc.contributor.author Chintu, Namwinga en_ZA
dc.contributor.author Chi, Benjamin H en_ZA
dc.date.accessioned 2015-11-23T12:38:11Z
dc.date.available 2015-11-23T12:38:11Z
dc.date.issued 2012 en_ZA
dc.identifier.citation Ekouevi, D. K., Stringer, E., Coetzee, D., Tih, P., Creek, T., Stinson, K., ... & Dabis, F. (2012). Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study. PLoS One, 7(1), e29823. doi:10.1371/journal.pone.0029823 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15360
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0029823
dc.description.abstract BACKGROUND: Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT) coverage in sub-Saharan are poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: We conducted surveys in health facilities with active PMTCT services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Data was compiled via direct observation and exit interviews. We constructed composite scores to describe provision of PMTCT services across seven topical areas: antenatal quality, PMTCT quality, supplies available, patient satisfaction, patient understanding of medication, and infrastructure quality. Pearson correlations and Generalized Estimating Equations (GEE) to account for clustering of facilities within countries were used to evaluate the relationship between the composite scores, total time of visit and select individual variables with PMTCT coverage among women delivering. Between July 2008 and May 2009, we collected data from 32 facilities; 78% were managed by the government health system. An opt-out approach for HIV testing was used in 100% of facilities in Zambia, 63% in Cameroon, and none in Côte d'Ivoire or South Africa. Using Pearson correlations, PMTCT coverage (median of 55%, (IQR: 33-68) was correlated with PMTCT quality score (rho = 0.51; p = 0.003); infrastructure quality score (rho = 0.43; p = 0.017); time spent at clinic (rho = 0.47; p = 0.013); patient understanding of medications score (rho = 0.51; p = 0.006); and patient satisfaction quality score (rho = 0.38; p = 0.031). PMTCT coverage was marginally correlated with the antenatal quality score (rho = 0.304; p = 0.091). Using GEE adjustment for clustering, the, antenatal quality score became more strongly associated with PMTCT coverage (p<0.001) and the PMTCT quality score and patient understanding of medications remained marginally significant. Conclusions/RESULTS: We observed a positive relationship between an antenatal quality score and PMTCT coverage but did not identify a consistent set of variables that predicted PMTCT coverage. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Antenatal care en_ZA
dc.subject.other HIV en_ZA
dc.subject.other Côte d'Ivoire en_ZA
dc.subject.other Pregnancy en_ZA
dc.subject.other South Africa en_ZA
dc.subject.other Zambia en_ZA
dc.subject.other Cameroon en_ZA
dc.subject.other Infants en_ZA
dc.title Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2012 Ekouevi et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image


Files in this item

This item appears in the following Collection(s)

Show simple item record

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.