Razzaq Amina, Stephenson Niamh, Raynes-Greenow Camille, Travaglia Joanne, Alam Neeloy Ashraful
Sydney School of Public Health, The University of Sydney, Faculty of Medicine and Health, Sydney Australia; School of Public Health and Community Medicine, Samuels Building (F25), University of New South Wales, Kensington, NSW 2033, Australia.
School of Public Health and Community Medicine, Samuels Building (F25), University of New South Wales, Kensington, NSW 2033, Australia.
Midwifery. 2023 May;120:103634. doi: 10.1016/j.midw.2023.103634. Epub 2023 Feb 19.
Human immunodeficiency virus (HIV) counselling and testing plays a significant role in the prevention of mother-to-child transmission of HIV. HIV counselling and testing during pregnancy is an essential gateway for HIV prevention, timely treatment, and care services. Lack of proper counselling could jeopardise the quality of services. This paper aims to understand the relationship between the government employed hospital healthcare workers and the Non-Governmental Organisation based counsellors while providing HIV counselling and testing services to pregnant women attending antenatal clinic in one of the main hospitals in Suva, Fiji. Data were collected via individual, in-depth, interviews held in a single hospital and an associated reproductive health centre in Suva in April-May 2013. A total of 15 healthcare providers including doctors (n = 4), midwives (n = 5), nurses (n = 4), and counsellors (n = 2) were interviewed. The data were analysed using thematic analysis. Ethical approvals were obtained. We found that there was tension between the government employed hospital healthcare workers and the Non-Governmental Organisation based counsellors involved in the provision of HIV counselling and testing services to pregnant women. The predominant causes of tension were poor referral for HIV test counselling, long counselling time, lack of cooperation and conflict due to the differences in counselling approaches. Tension between the government employed hospital healthcare workers and the Non- Governmental Organisation based HIV counsellors appear to be the main challenge to effective provision of HIV test counselling services in the hospital. Ongoing tension between both groups could restrict healthcare workers abilities to provide quality HIV counselling services. Our findings would be useful in developing strategies to overcome tension amongst healthcare workers as it would be an imperative step in providing streamlined HIV counselling services to women attending antenatal clinic in Fiji.
人类免疫缺陷病毒（HIV）咨询与检测在预防HIV母婴传播中发挥着重要作用。孕期的HIV咨询与检测是HIV预防、及时治疗及护理服务的关键入口。缺乏恰当的咨询可能会危及服务质量。本文旨在了解在斐济苏瓦一家主要医院为产前门诊孕妇提供HIV咨询与检测服务时，政府聘用的医院医护人员与非政府组织的咨询师之间的关系。2013年4月至5月，通过在苏瓦一家医院及相关生殖健康中心进行的个人深度访谈收集数据。共采访了15名医疗服务提供者，包括医生（n = 4）、助产士（n = 5）、护士（n = 4）和咨询师（n = 2）。采用主题分析法对数据进行分析。已获得伦理批准。我们发现，在为孕妇提供HIV咨询与检测服务方面，政府聘用的医院医护人员与非政府组织的咨询师之间存在紧张关系。紧张关系的主要原因包括HIV检测咨询的转诊不佳、咨询时间过长、缺乏合作以及咨询方法差异导致的冲突。政府聘用的医院医护人员与非政府组织的HIV咨询师之间的紧张关系似乎是医院有效提供HIV检测咨询服务的主要挑战。两组之间持续存在的紧张关系可能会限制医护人员提供高质量HIV咨询服务的能力。我们的研究结果将有助于制定策略来克服医护人员之间的紧张关系，因为这对于为斐济产前门诊的女性提供简化的HIV咨询服务而言是至关重要的一步。
