Assessment of Provider Initiated Testing and Counseling Implementation Among Health Care Providers in Public Health Facilities in Budaka District.

Abstract

HIV testing and counseling (HTC), has for long been recognized as a critical component of a comprehensive HIV program, it‟s the entry point for accessing needed HIV prevention, treatment and care, and support services. However, according to the who report in 2008 12% of the population in the developing countries had ever had an HIV test and received their test results, and a median of 20 percent of people living with HIV knew their HIV status this was at a time when HIV testing was largely client initiated(WHO 2008). As part of a strategy to increase HIV testing uptake, WHO has recommended provider initiated testing and counseling (PITC) whereby HIV testing is “recommended by health care providers to persons attending health care facilities as a standard component of medical care” (WHO 2007,). In Budaka district that has OPD utilization rates of 90% of its 179800 population only 33.3% of the population was tested in 2011/12 financial year therefore going by the recommendation of the WHO (2007) raising questions on the implementation of the guidelines that were officially launched by the ministry of health in 2007. Methodology A cross sectional descriptive study that used quantitative and qualitative data in a triangulation. Using disproportionate stratified random sampling 112 health care providers were interviewed and 9 focus group discussions were be held in the district for the managers, HCPs, and patients. Findings 51.8% of the health care providers are implementing provider initiated testing and counseling for the clients that are seeking health care in facilities, however 76% of the health care providers initiate HIV testing for all the patients, 36.6% of the health care providers reported to be carrying out pre-test counseling for the clients that are in the facility while 92.9% of the health care providers reported to be carrying out post test counseling.

Work load, stock out ,lack of orientation on PITC among the health care providers were the factors that undermine the implementation of provider initiated testing and counseling While initiation of HIV testing and counseling for all the clients by the health care providers, marital status of the health care providers, supervision of the health care provider, providing sufficient information to clients before testing for HIV, period the health care providers have been in service, and the period the laboratory is operational are associated with the PITC. The challenge for mothers attending ANC services is the fact that they are denied the services in the health facilities by the health care providers if the they do not present with their husbands for antenatal care. Conclusion Provider initiated testing and counseling is being implemented in Budaka district however because work load and lack of orientation by the health care providers, the guidelines by WHO that were launched MOH are not being followed, the challenges identified need to addressed in order for the district to realize the full potential of provider initiated testing and counseling.