Asefa Anteneh, Mitike Getnet
School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
BMC Pregnancy Childbirth. 2014 Feb 1;14:57. doi: 10.1186/1471-2393-14-57.
The coverage and uptake of prevention of mother-to-child transmission (PMTCT) of HIV services has remained very low in Ethiopia. One of the pillars of improving quality of health services is measuring and addressing client satisfaction. In Ethiopia, information about the quality of PMTCT services regarding client satisfaction is meager.
A facility-based cross-sectional study using quantitative methods was conducted in Adama town. We interviewed 423 pregnant women and 31 health providers from eight health facilities. Satisfaction of clients was measured using a standard questionnaire adapted from the UNAIDS best practices collection on HIV/AIDS. Bivariate and multivariate logistic regression analyses were used to identify factors associated with clients' satisfaction.
About three-fourth (74.7%) of clients reported that they were satisfied with the PMTCT services provided by the health facilities. However, a much lower proportion (39%) of the total respondents (pregnant women who underwent an ANC follow-up session), said they received and understood the messages related to mother-to-child transmission (MTCT) of HIV and PMTCT. The main challenges reported by service providers were lack of training, lack of feedback on job performance and inadequate pay. Clients' satisfaction with PMTCT service was found to be associated with liking the discussion they had with their counselor, non-preference to a different counselor with regards to sex and/or age and not seeing the same ANC counselor before and after HIV test.
Although 74.7% of clients were satisfied, the majority did not have a good understanding of the counseling on MTCT and PMTCT. We recommend more efforts to be exerted on improving provider-client communication, devising ways of increasing clients' satisfaction and designing an effective motivation strategy for service providers to enhance the status of PMTCT services.
在埃塞俄比亚，预防母婴传播（PMTCT）艾滋病毒服务的覆盖范围和利用率一直很低。提高卫生服务质量的支柱之一是衡量并解决客户满意度问题。在埃塞俄比亚，关于客户满意度方面的预防母婴传播服务质量的信息匮乏。
在阿达马镇开展了一项采用定量方法的基于机构的横断面研究。我们采访了来自八个卫生机构的423名孕妇和31名卫生服务提供者。使用从联合国艾滋病规划署关于艾滋病毒/艾滋病的最佳实践汇编中改编的标准问卷来衡量客户满意度。采用双变量和多变量逻辑回归分析来确定与客户满意度相关的因素。
约四分之三（74.7%）的客户报告称，他们对卫生机构提供的预防母婴传播服务感到满意。然而，在全部受访者（接受过产前检查随访的孕妇）中，只有低得多的比例（39%）表示他们收到并理解了与艾滋病毒母婴传播（MTCT）和预防母婴传播相关的信息。服务提供者报告的主要挑战包括缺乏培训、缺乏对工作表现的反馈以及薪酬不足。发现客户对预防母婴传播服务的满意度与喜欢与咨询员进行的讨论、在性别和/或年龄方面不偏好更换咨询员以及在艾滋病毒检测前后未见到同一名产前检查咨询员有关。
尽管74.7%的客户表示满意，但大多数人对母婴传播和预防母婴传播的咨询没有很好的理解。我们建议加大力度改善医患沟通，设计提高客户满意度的方法，并为服务提供者制定有效的激励策略，以提升预防母婴传播服务的水平。
