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Analysis of the prevention of mother-to-child transmission (PMTCT) service utilization in Ethiopia: 2006-2010.

Nigatu T, Woldegebriel Y - Reprod Health (2011)

Bottom Line: The prevalence of HIV at PMTCT sites has shown a four-fold decrease during the five-year period.This study has found that only 53% of known HIV-positive mothers and 48% of known HIV-exposed infants have received ARV prophylaxis.Based on assumption of constant HIV prevalence, the estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health, AIDS, Population and Nutrition Office, USAID/Ethiopia, P.O. Box 1014, Addis Ababa, Ethiopia. tilahunigatu@gmail.com

ABSTRACT

Introduction: Although progressive improvements have been made in the coverage and quality of prevention of HIV/AIDS mother-to-child transmission (PMTCT) services in Ethiopia, the national coverage remained persistently low. Analysis of the cascaded PMTCT services can reveal the advancements made and the biggest hurdles faced during implementation.

Objective: To examine the progresses and unaddressed needs in access and utilization of PMTCT services in Ethiopia from 2006 to 2010 thereby developing best-fit regression models to predict the values of key PMTCT indicators at critical future points.

Methods: Five-year national level PMTCT data were analyzed in a cascaded manner. Five levels of analysis were used for ten major PMTCT indicators. These included description of progress made, assessment of unaddressed needs, developing best-fit models, prediction for future points and estimation using constant prevalence. Findings were presented using numerical and graphic summaries.

Results: Based on the current trend, Ethiopia could achieve universal ANC coverage by 2015. The prevalence of HIV at PMTCT sites has shown a four-fold decrease during the five-year period. This study has found that only 53% of known HIV-positive mothers and 48% of known HIV-exposed infants have received ARV prophylaxis. Based on assumption of constant HIV prevalence, the estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies.

Conclusion: There has been a remarkable improvement in the potential coverage of PMTCT services due to rapid increase in the number of PMTCT service outlets. However, the actual coverage remained low. Integration of PMTCT services with grassroots level health systems could unravel the problem.

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From ANC attendance to HIV test in the PMTCT cascade of Ethiopia: 2006-2010.
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Figure 8: From ANC attendance to HIV test in the PMTCT cascade of Ethiopia: 2006-2010.

Mentions: All the service utilization steps from ANC attendance to the acceptance of HIV testing followed an increasing pattern during the five-year period. As shown in the figure below, the largest hurdle has been in the difference between the proportion of mothers who attended ANC and proportion of mothers who attended ANC at PMTCT sites. Acceptance for HIV testing among those pregnant mothers who were counseled for HIV has shown significant improvement; declining HIV counseling after presenting for ANC at PMTCT sites and refusing HIV testing after counseling have shown progressive reductions during the study period. As indicated in the figure below, the proportion of ANC attendance at PMTCT sites has shown a 15% increase, while all the remaining three rising indicators have shown at least 20% increase during the study period (Figure 8).


Analysis of the prevention of mother-to-child transmission (PMTCT) service utilization in Ethiopia: 2006-2010.

Nigatu T, Woldegebriel Y - Reprod Health (2011)

From ANC attendance to HIV test in the PMTCT cascade of Ethiopia: 2006-2010.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3094274&req=5

Figure 8: From ANC attendance to HIV test in the PMTCT cascade of Ethiopia: 2006-2010.
Mentions: All the service utilization steps from ANC attendance to the acceptance of HIV testing followed an increasing pattern during the five-year period. As shown in the figure below, the largest hurdle has been in the difference between the proportion of mothers who attended ANC and proportion of mothers who attended ANC at PMTCT sites. Acceptance for HIV testing among those pregnant mothers who were counseled for HIV has shown significant improvement; declining HIV counseling after presenting for ANC at PMTCT sites and refusing HIV testing after counseling have shown progressive reductions during the study period. As indicated in the figure below, the proportion of ANC attendance at PMTCT sites has shown a 15% increase, while all the remaining three rising indicators have shown at least 20% increase during the study period (Figure 8).

Bottom Line: The prevalence of HIV at PMTCT sites has shown a four-fold decrease during the five-year period.This study has found that only 53% of known HIV-positive mothers and 48% of known HIV-exposed infants have received ARV prophylaxis.Based on assumption of constant HIV prevalence, the estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health, AIDS, Population and Nutrition Office, USAID/Ethiopia, P.O. Box 1014, Addis Ababa, Ethiopia. tilahunigatu@gmail.com

ABSTRACT

Introduction: Although progressive improvements have been made in the coverage and quality of prevention of HIV/AIDS mother-to-child transmission (PMTCT) services in Ethiopia, the national coverage remained persistently low. Analysis of the cascaded PMTCT services can reveal the advancements made and the biggest hurdles faced during implementation.

Objective: To examine the progresses and unaddressed needs in access and utilization of PMTCT services in Ethiopia from 2006 to 2010 thereby developing best-fit regression models to predict the values of key PMTCT indicators at critical future points.

Methods: Five-year national level PMTCT data were analyzed in a cascaded manner. Five levels of analysis were used for ten major PMTCT indicators. These included description of progress made, assessment of unaddressed needs, developing best-fit models, prediction for future points and estimation using constant prevalence. Findings were presented using numerical and graphic summaries.

Results: Based on the current trend, Ethiopia could achieve universal ANC coverage by 2015. The prevalence of HIV at PMTCT sites has shown a four-fold decrease during the five-year period. This study has found that only 53% of known HIV-positive mothers and 48% of known HIV-exposed infants have received ARV prophylaxis. Based on assumption of constant HIV prevalence, the estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies.

Conclusion: There has been a remarkable improvement in the potential coverage of PMTCT services due to rapid increase in the number of PMTCT service outlets. However, the actual coverage remained low. Integration of PMTCT services with grassroots level health systems could unravel the problem.

Show MeSH
Related in: MedlinePlus