Political instability and supply-side barriers undermine the potential for high participation in HIV testing for the prevention of mother-to-child transmission in Guinea-Bissau: A retrospective cross-sectional study.

摘要: Background The World Health Organization recommends HIV testing is included in routine screening tests for all pregnant women order to prevent mother-to-child-transmission of and reduce maternal morbidity mortality. Objectives To assess the proportion approached tested at delivery factors associated with non-testing maternity ward Simao Mendes National Hospital (HNSM) Bissau, Guinea-Bissau. Methods We conducted a retrospective cross-sectional study among presenting from June 2008 until May 2013. During period, national policy opt-out HIV-testing delivery. Modified Poisson regression models were used examine association characteristics testing. Time trends determined using Pearson’s χ2 test. Results Seventy-seven percent (24,217/31,443) counselled regarding PMTCT, whom 99.6% (24,107/24,217) proceeded provision labour increased 38.1% (1,514/3973) 95.7% (2,021/2,113) 2013, p<0.001. There four distinct periods (two or more consecutive calendar months) when less than 50% delivering HNSM tested. Periods political instability significantly not (adjusted prevalence ratio [APR] 1.79; 95% CI 1.73–1.84), as was lower educational status (APR 1.05; 1.00–1.10), admission during evenings/nights 1.01–1.09) on Sundays 1.14; 1.07–1.22) Mondays 1.12; 1.05–1.19). Conclusions Rapid scale-up PMTCT services high coverage possible this resource-limited setting but suffered regular interruptions, most likely because test stock-outs. Establishing proper stock management systems back-up plans required ensure maintenance health system core functions increase resilience.