An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme

• Published in: BMC health services research 2012-05, Vol.12 (1), p.131-131, Article 131
• Main Authors: Sibanda, Euphemia L, Hatzold, Karin, Mugurungi, Owen, Ncube, Getrude, Dupwa, Beatrice, Siraha, Pester, Madyira, Lydia K, Mangwiro, Alexio, Bhattacharya, Gaurav, Cowan, Frances M
• Format: Article
• Language: English
• Subjects: Administrative agencies; Adolescent; Adult; Aged; Analysis; Care and treatment; Child welfare; Children; Clinics; Counseling; Data collection; Diffusion of Innovation; Disease prevention; Female; Focus Groups; Government Programs; Health aspects; Health care; HIV; HIV (Viruses); HIV Seropositivity - diagnosis; HIV testing; Hospitals; Human immunodeficiency virus; Humans; Informed consent; Interviews; Male; Medical personnel; Medical research; Medical tests; Medicine, Experimental; Middle Aged; Nurses; Qualitative Research; Reagent Kits, Diagnostic - statistics & numerical data; Reagent Kits, Diagnostic - supply & distribution; Studies; Surveys and Questionnaires; Tuberculosis; Wellness programs; Workers; Young Adult; Zimbabwe
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/1472-6963-12-131

Provider-initiated HIV testing and counselling (PITC) is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW) perceptions of the PITC programme. Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1) assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2) in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3) Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics). All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.