Quality assurance of HIV counselling and testing for the prevention of mother-to-child transmission of HIV in Rivers State, Nigeria

As the HIV/AIDS pandemic continues especially in the developing countries, the evaluation of quality and effectiveness of interventions aimed at its control remains very critical. A descriptive, cross-sectional study was carried out among HIV/AIDS counsellors providing counselling services to pregnant women attending antenatal clinics in all the 34 secondary health care facilities in Rivers State between September and December 2009 to assess the quality of HIV counselling services offered by these counsellors. A semi-structured, self-administered questionnaire was used to elicit relevant information on counsellors' performances and extent of compliance with the national guidelines on pre-and post test counselling for PMTCT. Data was analyzed using the Epi-Info version 6.04d statistical software package. Confidence limit of 95% was set at a significance level at P=0.05. The average duration of counseling was twenty minutes, with only one or two counsellors in attendance. Most of the counsellors, 228 (59.4%) out of the 384 (95%CI=53.0-65.8) said they were only supervised occasionally. Majority of the counsellors 369(96.1%) did not have access to copies of the national guidelines for VCT counselling for PMTCT and the checklist for providing counselling services. Similarly, other resources for counselling such as television and video sets, posters and banners were in short supply. Important issues in post-test counselling such as information about assessing ongoing emotional and social support services, making plans for the future and future fertility, information on delivery options, nutrition and the need for follow up and adherence counselling were often left out. Counsellors' motivation and the institutionalization of supportive supervision are advocated to enhance the quality of HIV counselling at PMTCT centres in Rivers StateKey words: HIV/AIDS, counselling quality assurance, PMTCT services, Rivers State Nigeria