Supply-side dimensions and dynamics of integrating HIV testing and counselling into routine antenatal care: a facility assessment from Morogoro Region, Tanzania.

摘要: Integration of HIV into RMNCH (reproductive, maternal, newborn and child health) services is an important process addressing the disproportionate burden among mothers children in sub-Saharan Africa. We assess structural inputs processes care that support testing counselling routine antenatal to understand supply-side dynamics critical scaling up further integration prior recent changes policy Tanzania. This study, as a part maternal health program evaluation Morogoro Region, Tanzania, drew from assessment centers with 18 facility checklists, 65 quantitative 57 qualitative provider interviews, 203 observations. Descriptive analyses were performed data using Stata 12.0, analyzed thematically managed by Atlas.ti. Limitations inputs, such infrastructure, supplies, staffing, constrain potential for services. While including waiting areas, appeared adequate, long queues small rooms made private confidential difficult individual women. Unreliable stocks test kits, essential medicines, infection prevention equipment also had implications provider-patient relationships, reported decreases women’s seeking at centers. In addition, low staffing levels increase workloads lower motivation workers. Despite adequate knowledge messages, sessions brief incomplete messages conveyed pregnant coping mechanisms, scheduling clinical activities on different days, limited service availability. Antenatal strategic entry point delivery tests framing patient-provider relations, which together underpin remaining continuum care. Supply-side deficiencies delivering during indicate shortcomings quality provided. These must be addressed if integrating result improved outcomes.