Prevention of mother-to-child transmission (PMTCT) of HIV services in Adama town, Ethiopia: clients' satisfaction and challenges experienced by service providers.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia. antex98@yahoo.com.
Anteneh
A
Asefa
Getnet
G
Mitike
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003376:Counseling / Q000592:standards; D003430:Cross-Sectional Studies; D004650:Employee Performance Appraisal; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission*; D006282:Health Personnel / Q000191:economics / Q000193:education; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011295:Prenatal Care / Q000592:standards*; D011369:Professional-Patient Relations; D058996:Quality Improvement; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult