ASSESSMENT OF THE QUALITY OF HIV TESTING AND COUNSELLING IN ANTENATAL CLINICS IN SELECTED PRIVATE HEALTH FACILITIES IN AYAWASO SUB-METRO, ACCRA

ABSTRACT Introduction: Mother-to-Child-Transmission (MTCT) of HIV is a global health problem. Recent advances in the Prevention of Mother-to-Child Transmission (PMTCT) program have provided the means to drastically reduce infant mortality associated with HIV/AIDS. Quality HIV testing and counselling (HTC) is an important gateway to PMTCT services and concerted effort has been made by the National AIDS/STI Control Program (NACP) to scale up the provision of antenatal HTC in Ghana. Some concerns have been raised about the quality of HTC provided in antenatal clinics especially in the context of rapid scale-up programs. Greater Accra was one of three regions that recorded an increase in ANC HIV in 2013. Ayawaso, a densely populated sub-metro in Accra has the highest concentration of private health facilities, however, the quality of HTC in antenatal clinics in private health facilities within the sub-metro is unknown. Objectives: The general objective of this study was to assess the quality of HTC services offered in antenatal clinics in private health facilities in Ayawaso in relation to national guidelines. The specific objectives were: to analyse the institutional capacity of private health facilities to offer quality HTC; to assess the patient‟s perceptions of quality of care rendered in the HTC process in private health facilities and to describe the provider‟s perception of quality of HTC services and constraints. Methods: The study is a descriptive cross sectional, mixed methods research carried out in two purposively selected private health facilities in Ayawaso, namely: Salvation Army Urban Aid Health Centre and Hajia Damata Maternity home. Quantitative data were collected using a health facility assessment tool and client exit questionnaires; qualitative data were collected using observations and interviews with key HTC staff. Findings: The study found that there were inadequate structures in place for the provision of quality HTC. While some aspects of the HTC process were adhered to, principles of informed consent and confidentiality were breached. Both healthcare workers and clients expressed satisfaction with quality of HTC. Conclusion: Private health facilities have weak structures for the provision of quality HTC. Private health facilities adhere in part to the National Policy guidelines with deviations in obtaining informed consent and communicating confidentiality to the clients. In the perception of the clients and healthcare workers, quality of HTC was good.