Pediatric HIV treatment, care and support services at health center levels in Ethiopia

Abstract

Back ground: In Ethiopia there is low enrolment rate among HIV patients in general and pediatric HIV cases in particular. There are interventions done to improve pediatric HIV care at primary health care level, but so far there have never been any assessments done. Objectives: is to compare the skills of health care providers on pediatric HIV care & treatment and compares the enrollment of pediatric patients for HIV care and follow up at the supported and nonsupported health centers. Methods: Analytic – retrospective cohort study was conducted on 79 supported and 39 non supported health centers in Oromia, Tigrai, Amhara and SNNPR. The supported health centers were provided with training and regular mentorship on Pediatric HIV care, support and treatment for two years. Data on Skills of health care providers was measured with standardized tool that was pre-tested in Addis Ababa health centers. Data on enrollment of HIV infected and exposed children were collected. Data was entered into Epi-Info and analyzed using SPSS for windows. Results: Skills on clinical examination and diagnosis (RR = 1.72; 95%CI; 1.23, 2.41), skill in clinical laboratory (RR=1.48 95% CI; 1.08, 2.03), were found to be Good ≥70% in the supported health centers compared with the non-supported. Similarly, Cotrimoxazole dosing skills (RR = 1.34; 95% CI; 1.11, 1.62), skill on follow up of ART Patients (RR= 3.02 95% CI; 1.6, 5.7), skill on HIV Exposed infant follow up and management (RR= 4.57; 95% CI; 1.66, 12.6) and keeping proper medical records (RR=3.1; 95% CI; 1.83, 5.2) were again better in the supported health centers. A paired sample T- test showed statistically significant result ( P-value =0.001) with mean increment of 20.61 in the number of pediatrics patients on HIV care and mean increment of 13.93 in patients on ART in the supported health centers in the two years period ( Dec 2008-2010) . Conclusions: this study showed that most health workers in the supported health centers had good skill in managing pediatrics HIV patients and the rate of pediatrics HIV patients’ enrollment rate was found to be significantly increased in the supported health centers, hence more health centers should be supported technically via training and mentorship to scale down the pediatrics HIV care services to Primary health care level to scale up the program.