Cargando…

Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children

BACKGROUND: Prevention of mother-to-child transmission has been considered as not a simple intervention but a comprehensive set of interventions requiring capable health workers. Viet Nam's extensive health care system reaches the village level, but still HIV-infected mothers and children have...

Descripción completa

Detalles Bibliográficos
Autores principales: Nguyen, Thu Anh, Oosterhoff, Pauline, Pham, Yen Ngoc, Hardon, Anita, Wright, Pamela
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684067/
https://www.ncbi.nlm.nih.gov/pubmed/19439094
http://dx.doi.org/10.1186/1478-4491-7-39
_version_ 1782167159330308096
author Nguyen, Thu Anh
Oosterhoff, Pauline
Pham, Yen Ngoc
Hardon, Anita
Wright, Pamela
author_facet Nguyen, Thu Anh
Oosterhoff, Pauline
Pham, Yen Ngoc
Hardon, Anita
Wright, Pamela
author_sort Nguyen, Thu Anh
collection PubMed
description BACKGROUND: Prevention of mother-to-child transmission has been considered as not a simple intervention but a comprehensive set of interventions requiring capable health workers. Viet Nam's extensive health care system reaches the village level, but still HIV-infected mothers and children have received inadequate health care services for prevention of mother-to-child transmission. We report here the health workers' perceptions on factors that lead to their failure to give good quality prevention of mother-to-child transmission services. METHODS: Semistructured interviews with 53 health workers and unstructured observations in nine health facilities in Hanoi were conducted. Selection of respondents was based on their function, position and experience in the development or implementation of prevention of mother-to-child transmission policies/programmes. RESULTS: Factors that lead to health workers' failure to give good quality services for prevention of mother-to-child transmission include their own fear of HIV infection; lack of knowledge on HIV and counselling skills; or high workloads and lack of staff; unavailability of HIV testing at commune level; shortage of antiretroviral drugs; and lack of operational guidelines. A negative attitude during counselling and provision of care, treating in a separate area and avoidance of providing service at all were seen by health workers as the result of fear of being infected, as well as distrust towards almost all HIV-infected patients because of the prevailing association with antisocial behaviours. Additionally, the fragmentation of the health care system into specialized vertical pillars, including a vertical programme for HIV/AIDS, is a major obstacle to providing a continuum of care. CONCLUSION: Many hospital staff were not being able to provide good care or were even unwilling to provide appropriate care for HIV-positive pregnant women The study suggests that the quality of prevention of mother-to-child transmission service could be enhanced by improving communication and other skills of health workers, providing them with greater support and enhancing their motivation. Reduction of workload would also be important. Development of a practical strategy is needed to strengthen and adapt the referral system to meet the needs of patients.
format Text
id pubmed-2684067
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-26840672009-05-20 Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children Nguyen, Thu Anh Oosterhoff, Pauline Pham, Yen Ngoc Hardon, Anita Wright, Pamela Hum Resour Health Research BACKGROUND: Prevention of mother-to-child transmission has been considered as not a simple intervention but a comprehensive set of interventions requiring capable health workers. Viet Nam's extensive health care system reaches the village level, but still HIV-infected mothers and children have received inadequate health care services for prevention of mother-to-child transmission. We report here the health workers' perceptions on factors that lead to their failure to give good quality prevention of mother-to-child transmission services. METHODS: Semistructured interviews with 53 health workers and unstructured observations in nine health facilities in Hanoi were conducted. Selection of respondents was based on their function, position and experience in the development or implementation of prevention of mother-to-child transmission policies/programmes. RESULTS: Factors that lead to health workers' failure to give good quality services for prevention of mother-to-child transmission include their own fear of HIV infection; lack of knowledge on HIV and counselling skills; or high workloads and lack of staff; unavailability of HIV testing at commune level; shortage of antiretroviral drugs; and lack of operational guidelines. A negative attitude during counselling and provision of care, treating in a separate area and avoidance of providing service at all were seen by health workers as the result of fear of being infected, as well as distrust towards almost all HIV-infected patients because of the prevailing association with antisocial behaviours. Additionally, the fragmentation of the health care system into specialized vertical pillars, including a vertical programme for HIV/AIDS, is a major obstacle to providing a continuum of care. CONCLUSION: Many hospital staff were not being able to provide good care or were even unwilling to provide appropriate care for HIV-positive pregnant women The study suggests that the quality of prevention of mother-to-child transmission service could be enhanced by improving communication and other skills of health workers, providing them with greater support and enhancing their motivation. Reduction of workload would also be important. Development of a practical strategy is needed to strengthen and adapt the referral system to meet the needs of patients. BioMed Central 2009-05-13 /pmc/articles/PMC2684067/ /pubmed/19439094 http://dx.doi.org/10.1186/1478-4491-7-39 Text en Copyright © 2009 Nguyen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Nguyen, Thu Anh
Oosterhoff, Pauline
Pham, Yen Ngoc
Hardon, Anita
Wright, Pamela
Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children
title Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children
title_full Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children
title_fullStr Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children
title_full_unstemmed Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children
title_short Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children
title_sort health workers' views on quality of prevention of mother-to-child transmission and postnatal care for hiv-infected women and their children
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684067/
https://www.ncbi.nlm.nih.gov/pubmed/19439094
http://dx.doi.org/10.1186/1478-4491-7-39
work_keys_str_mv AT nguyenthuanh healthworkersviewsonqualityofpreventionofmothertochildtransmissionandpostnatalcareforhivinfectedwomenandtheirchildren
AT oosterhoffpauline healthworkersviewsonqualityofpreventionofmothertochildtransmissionandpostnatalcareforhivinfectedwomenandtheirchildren
AT phamyenngoc healthworkersviewsonqualityofpreventionofmothertochildtransmissionandpostnatalcareforhivinfectedwomenandtheirchildren
AT hardonanita healthworkersviewsonqualityofpreventionofmothertochildtransmissionandpostnatalcareforhivinfectedwomenandtheirchildren
AT wrightpamela healthworkersviewsonqualityofpreventionofmothertochildtransmissionandpostnatalcareforhivinfectedwomenandtheirchildren