Implementation Of Pmtct Option B+ In The Techiman Municipality: Client Satisfaction And Service Provider Challenges

ABSTRACT

Background: Ghana including 20 other countries in 2009 were earmarked for rapid PMTCT interventions scale-up within their primary care system for maternal and child health. This intervention became operationalized in June 2015 with the introduction of the PMTCT option B+ where HIV-positive women are initiated on lifelong ARVs regardless of their CD4 count upon immediate diagnosis of HIV and infants born to HIV-positive women receive daily zidovudine (AZT) for the first 4–6 weeks of life.

Objectives: To explore the socio-cultural, facility, and service related factors that influence implementation of PMTCT Option B+ in the Techiman Municipality.

Methods: The study was a facility-based cross sectional study, which employed the mixed method approach. Qualitative and quantitative methods were used to interact with HIV positive women to find the socio-cultural, facility and service receipt factors that influenced client satisfaction whereas solely qualitative method was used to identify challenges service providers encountered under PMTCT Option B+.

Results: HIV positive pregnant and nursing mothers as well as their service providers were involved in this study with their ages ranging from 17 years to 53 years. A little over 85 percent of the HIV positive women were less than 24 years with only 14.4 percent over 24 years. More than half (69.9%) were married with the remaining either separated, never married, cohabiting, divorced or widowed. Service providers included Medical Officers, Nurse midwives among others. Of other socio-demographic characteristics of respondents assessed, respondents‟ type of residence was statistically a significant predictor of client satisfaction (AOR: 3.256 95% CI. 1.556-6.813). None of the socio-cultural factors assessed was statistically significantly associated with client satisfaction. Facility and

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service related factors including waiting time (AOR: 0.151 95% CI. 0.066-0.347) and experience of stigma from service providers (AOR 0.070 95% CI. 0.007-0.731) made statistically significant difference with client satisfaction. Other facility and service related factors like medical tests carried out at the facility (AOR: 0.405 95% CI. 0.079-2.021), experience of side effects of medications (AOR: 1.844 CI 95% 0.861-3.951) and information given on medications (p