Linkage between VCT and Reproductive Health Services (FP; ANC and delivery) in two Public Facilities of Rural Ethiopia

ABSTRACT

Background: Linking of related health services or delivering services in an integrated setup is an indispensable undertaking to optimize utilization of scarce resources in developing countries like Ethiopia. However; very related services such as HIV/AIDS and reproductive health are mostly delivered not in an integrated setup and a lot of missedopportunities are observed. Method: A cross-sectional study was conducted to describe the linkage between VCT and reproductive health services in two public health facilities of rural Ethiopia. A total of 405 women who were attending family planning (FP); antenatal and delivery care services were interviewed with structured questionnaire. Moreover; using qualitative technique; service provider interview and direct service delivery observation were conducted. Results: It was found that almost half of the women coming to attend ANC; delivery and family planning services have sufficient knowledge about VCT. Overall; 80have favorable attitude towards VCT. Family planning (FP) clients have less favorable attitude and less knowledge compared to ANC and delivery care attendees. Only 46.9of women reported that they were informed about VCT during their current visit. About 32.4of FP; 62.8of ANC were informed by providers about VCT (P0.001). Similarly; 22.4of FP; 57.9of ANC attendees were advised to get tested by the providers (P0.001). Majority of ANC attendees were referred to the VCT sites as compared to FP clients which were found to be due to the existence of formal referral between the ANC and VCT clinics for PMTCT services. Use of IE/BCC materials to disseminate messages in different service delivery sites was very limited. FP counse- ling and contraceptives are not provided at the VCT sites and there is no referral to FP clinics for those who may need the services. Conclusion: The study revealed weak linkage between VCT and FP which was mainly due to shortage of trained manpower; lack of time to counsel clients; negligence; absence of clear guidelines and referral system and lack of follow up and supervision. Therefore; orientation of providers; development of clear referral guideline and supportive supervision are recommended to minimize such missed opportunities