Quality and quantity of antenatal HIV counselling in a PMTCT programme in Mombasa, Kenya
Quality and quantity of antenatal HIV counselling in a PMTCT programme in Mombasa, Kenya
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DOI：
10.1080/09540120500456425
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发表时间：
2006-04-01
影响因子：
1.7
通讯作者：
Temmerman, M
中科院分区：
文献类型：
--
作者：
Delva, W;Mutunga, L;Temmerman, M
最近在肯尼亚蒙巴萨进行的一项预防母婴传播实施研究报告指出，临床试验环境下的有效性与在现实生活中实施预防母婴传播规划时的有效性之间存在重要差距。因此，在常规设置产前艾滋病毒咨询的质量和数量进行了评价。通过艾滋病规划署出版的VCT评估工具，评估了辅导员的社交和沟通技巧、测试前后咨询会议期间的持续时间和涉及的主题。共观察和评估了14个小组教育会议、66个考试前咨询会议和50个考试后咨询会议。总的来说，咨询的频率和持续时间都很低。诸如窗口期和伙伴参与以及后续支助等关键议题的讨论是随意的。辅导员的社交和沟通技巧得到了高分，但信息很少被重复或总结。专门用于妇女接受产前VCT的时间有限，与她们本应接受的大量和全面的健康信息和建议形成鲜明对比。为使预防母婴传播取得最佳效果，应进行充分的检测前和检测后咨询，包括随访。我们建议在进行审计之前和指导下采取一些卫生系统干预措施。
A recent report from a PMTCT implementation study in Mombasa, Kenya, points at an important gap between the efficacy in clinical trial circumstances and the effectiveness of PMTCT programmes when implemented in real life. Hence, the quality and quantity of antenatal HIV counselling in a routine setting were appraised. The counsellors' social and communicative skills, duration and topics covered during pre- and post-test counselling sessions were assessed by means of the VCT assessment tools published by UNAIDS. A total of 14 group educational sessions, 66 pre- test counselling sessions and 50 post-test counselling sessions were observed and assessed. In general, the frequency and duration of the counselling was low. Crucial topics such as window period and partner involvement and follow-up support were covered haphazardly. The counsellor's social and communicative skills were given high marks, yet information was rarely repeated or summarized. The limited time dedicated to women receiving antenatal VCT contrasts with the heavy and comprehensive load of health information and advice they are supposed to receive. Ample pre- and post-test counselling including follow- up should be pursued for optimal effectiveness of PMTCT. We propose a number of health system interventions preceded and guided by ongoing audit.