Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health University of Arizona, Tucson, AZ, USA.
Department of Nursing Science, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
BMC Health Serv Res. 2022 Jun 11;22(1):769. doi: 10.1186/s12913-022-08152-6.
Implementation of interventions for the prevention of mother-to-child transmission (PMTCT) of HIV in low- and middle-income countries, faces several barriers including health systems challenges such as health providers' knowledge and use of recommended guidelines. This study assessed PMTCT providers' knowledge of national PMTCT guideline recommendations in Lagos, Nigeria.
This was a cross-sectional survey of a purposive sample of twenty-three primary health care (PHC) centers in the five districts of Lagos, Nigeria. Participants completed a self-administered 16-item knowledge assessment tool created from the 2016 Nigeria PMTCT guidelines. Research Electronic Data Capture (REDCap) was used for data entry and R statistical software used for data analysis. The Chi square test with a threshold of P < 0.05 considered as significant was used to test the hypothesis that at least 20% of service providers will have good knowledge of the PMTCT guidelines.
One hundred and thirteen (113) respondents participated in the survey. Most respondents knew that HIV screening at the first prenatal clinic was an entry point to PMTCT services (97%) and that posttest counselling of HIV-negative women was necessary (82%). Similarly, most respondents (89%) knew that early infant diagnosis (EID) of HIV should occur at 6-8 weeks of life (89%). However, only four (3.5%) respondents knew the group counselling and opt-out screening recommendation of the guidelines; 63% did not know that haematocrit check should be at every antenatal clinic visit. Forty-eight (42.5%) service providers had good knowledge scores, making the hypothesis accepted. Knowledge score was not influenced by health worker cadre (p = 0.436), training(P = 0.537) and professional qualification of ≤5 years (P = 0.43).
Service providers' knowledge of the PMTCT guidelines recommendations varied. The knowledge of group counselling and opt-out screening recommendations was poor despite the good knowledge of infant nevirapine prophylaxis. The findings highlight the need for training of service providers.
在中低收入国家实施预防母婴传播 (PMTCT) 的干预措施面临着许多障碍，包括卫生系统方面的挑战，例如卫生保健提供者对推荐指南的了解和使用。本研究评估了尼日利亚拉各斯的 PMTCT 提供者对国家 PMTCT 指南建议的了解程度。
这是一项对尼日利亚拉各斯五个区的 23 个初级保健中心的有目的样本进行的横断面调查。参与者完成了一份自我管理的 16 项知识评估工具，该工具是从 2016 年尼日利亚 PMTCT 指南中创建的。研究电子数据捕获 (REDCap) 用于数据输入，R 统计软件用于数据分析。使用卡方检验（阈值 P < 0.05 被认为具有统计学意义）来检验以下假设：至少 20%的服务提供者将对 PMTCT 指南有良好的了解。
共有 113 名（113 名）受访者参加了调查。大多数受访者知道在第一次产前诊所进行 HIV 筛查是 PMTCT 服务的切入点（97%），并且对 HIV 阴性妇女进行检测后咨询是必要的（82%）。同样，大多数受访者（89%）知道应该在婴儿 6-8 周龄时进行早期婴儿诊断（EID）艾滋病毒（89%）。然而，只有四名（3.5%）受访者知道指南中的群体咨询和选择筛查建议；63%的人不知道应该在每次产前检查时进行血细胞比容检查。48 名（42.5%）服务提供者的知识得分较高，因此假设成立。知识得分不受卫生工作者干部（p=0.436）、培训（p=0.537）和 ≤5 年专业资格（p=0.43）的影响。
服务提供者对 PMTCT 指南建议的了解程度参差不齐。尽管对婴儿使用奈韦拉平预防措施有较好的了解，但对群体咨询和选择筛查建议的了解程度较差。调查结果突出了对服务提供者进行培训的必要性。
