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Calidad de los cuidados antenatales y de parto antes y después de la implementación de un programa de prevención de la transmisión vertical de VIH en Costa de Marfil
Author(s) -
Delvaux Thérèse,
Diby Konan JeanPaul,
AkéTano Odile,
GohouKouassi Valérie,
Bosso Patrice Emery,
Buvé Anne,
Ronsmans Carine
Publication year - 2008
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2008.02105.x
Subject(s) - medicine , nevirapine , family medicine , health facility , confidentiality , cote d ivoire , human immunodeficiency virus (hiv) , nursing , transmission (telecommunications) , population , environmental health , obstetrics , health services , antiretroviral therapy , viral load , philosophy , electrical engineering , engineering , political science , humanities , law
Summary Objective To assess whether implementation of a prevention of mother‐to‐child HIV transmission (PMTCT) programme in Côte d’Ivoire improved the quality of antenatal and delivery care services. Methods Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002–2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations ( n = 606 before; n = 591 after) and deliveries ( n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. Results HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIV‐infected pregnant women received nevirapine. In addition, inter‐personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post‐partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% ( P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. Conclusions Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general.