Linkage between VCT and reproductive health services (FP, ANC and delivery) in two public facilities of rural Ethiopia

Abstract

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 missed
opportunities 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, 80% have favorable attitude towards VCT. Family planning (FP)
clients have less favorable attitude and less knowledge compared to ANC and delivery care attendees. Only 46.9% of
women reported that they were informed about VCT during their current visit. About 32.4% of FP, 62.8% of ANC
were informed by providers about VCT (P<0.001). Similarly, 22.4% of FP, 57.9% of ANC attendees were advised to
get tested by the providers (P<0.001). 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 counseling 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. [Ethiop.J.Health Dev. 2008;22(2):158-166]