Health facility factors and quality of services to prevent mother-to-child HIV transmission in Côte d’Ivoire, Kenya, and Mozambique
Open accessAbstract
This study aimed to identify facility-level characteristics associated with prevention of mother-to-child HIV transmission service quality. This cross-sectional study sampled 60 health facilities in Mozambique, Côte d’Ivoire, and Kenya (20 per country). Performance score – the proportion of pregnant women tested for HIV in first antenatal care visit, multiplied by the proportion of HIV-positive pregnant women who received appropriate antiretroviral medications – was calculated for each facility using routine data from 2012 to 2013. Facility characteristics were ascertained during on-site visits, including workload. Associations between facility characteristics and performance were quantified using generalized linear models with robust standard errors, adjusting for country. Over six months, facilities saw 38,611 first antenatal care visits in total. On-site CD4 testing, Pima CD4 machine, air conditioning, and low or high (but not mid-level) patient volume were each associated with higher performance scores. Each additional first antenatal care visit per nurse per month was associated with a 4% (95% confidence interval: 1%–6%) decline in the odds that an HIV-positive pregnant woman would receive both HIV testing and antiretroviral medications. Physician workload was only modestly associated with performance. Investments in infrastructure and human resources – particularly nurses – may be critical to improve prevent mother-to-child HIV transmission service delivery and protect infants from HIV.
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The quality of Option B+ services is dependent on specific health facility characteristics.
“Given that the quality of Option B+ services is dependent on specific health facility characteristics [22]”
Nurse staffing and workloads are strongly correlated with pregnant women completing steps along the complex cascade of Option B+ services.
“Nurse staffing and workloads are strongly correlated with pregnant women completing steps along the complex cascade of Option B+ services [22].”
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Self-citation
- Authors
- Rustagi, A. S., Gimbel, S., Nduati, R., Cuembelo, M. D. F., Wasserheit, J. N., Farquhar, C., Gloyd, S., Sherr, K., & with input from the SAIA Study Team
- Affiliations
- University of Washington (US)
- University of Nairobi (KE)
- Community Health Department, School of Medicine, University of Eduardo Mondlane, Maputo, Mozambique
- ORCID
- Venue
- International Journal of STD & AIDS
- Publisher
- SAGE Publications
- Published
- 2016-09-02
- Volume
- 28
- Issue
- 8
- Pages
- 788-799
- ISSN
- 0956-4624 (ISSN-L)
- 1758-1052
- PMC
- PMC5512542
- OpenAlex
- W2512289332
- Cited by
- 16
- References
- 24
- Citations by year
- 2024: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of STD & AIDS (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. President’s Emergency Plan for AIDS Relief
- National Institute of Mental Health (R01MH113435)
- National Institute of Allergy and Infectious Diseases (P30AI027757)
- Fogarty International Center (K02TW009207)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD075057)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- prevention of mother-to-child transmission of HIV, service quality, antenatal HIV testing, antiretroviral therapy in pregnancy, CD4 testing, nursing workload, health facility infrastructure, healthcare workers, Côte d'Ivoire, Kenya, Mozambique
- MeSH terms
- Cross-Sectional Studies, Female, Health Facilities, Health Services Accessibility, Humans, Infant, Cote d'Ivoire, Kenya, Mass Screening, Mothers, Mozambique, Prenatal Care, AIDS Serodiagnosis, HIV Infections, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, Antibiotic Prophylaxis, Anti-HIV Agents, Quality Indicators, Health Care
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