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

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dc.contributor.authorEkouevi, Didier Ken_ZA
dc.contributor.authorStringer, Elizabethen_ZA
dc.contributor.authorCoetzee, Daviden_ZA
dc.contributor.authorTih, Piusen_ZA
dc.contributor.authorCreek, Tracyen_ZA
dc.contributor.authorStinson, Kathrynen_ZA
dc.contributor.authorWestfall, Andrew Oen_ZA
dc.contributor.authorWelty, Thomasen_ZA
dc.contributor.authorChintu, Namwingaen_ZA
dc.contributor.authorChi, Benjamin Hen_ZA
dc.date.accessioned2015-11-23T12:38:11Z
dc.date.available2015-11-23T12:38:11Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationEkouevi, D. K., Stringer, E., Coetzee, D., Tih, P., Creek, T., Stinson, K., ... Chi, B. H. (2012). Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study. <i>PLoS One</i>, http://hdl.handle.net/11427/15360en_ZA
dc.identifier.chicagocitationEkouevi, Didier K, Elizabeth Stringer, David Coetzee, Pius Tih, Tracy Creek, Kathryn Stinson, Andrew O Westfall, Thomas Welty, Namwinga Chintu, and Benjamin H Chi "Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study." <i>PLoS One</i> (2012) http://hdl.handle.net/11427/15360en_ZA
dc.identifier.citationEkouevi, 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.0029823en_ZA
dc.identifier.ris TY - Journal Article AU - Ekouevi, Didier K AU - Stringer, Elizabeth AU - Coetzee, David AU - Tih, Pius AU - Creek, Tracy AU - Stinson, Kathryn AU - Westfall, Andrew O AU - Welty, Thomas AU - Chintu, Namwinga AU - Chi, Benjamin H AB - 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. DA - 2012 DB - OpenUCT DO - 10.1371/journal.pone.0029823 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study TI - Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study UR - http://hdl.handle.net/11427/15360 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15360
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0029823
dc.identifier.vancouvercitationEkouevi DK, Stringer E, Coetzee D, Tih P, Creek T, Stinson K, et al. Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study. PLoS One. 2012; http://hdl.handle.net/11427/15360.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2012 Ekouevi et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAntenatal careen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherCôte d'Ivoireen_ZA
dc.subject.otherPregnancyen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherZambiaen_ZA
dc.subject.otherCameroonen_ZA
dc.subject.otherInfantsen_ZA
dc.titleHealth facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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