Implementation of provider initiated HIV counseling and testing program in outpatients service in Rwanda. “case of catchment area of Muhima district Hospital’’

Abstract

Background: HIV/AIDS is an important public health problem despite important progress. The prevention remains up today the most effective way of fighting against HIV. Research has shown that testing is an important step toward behavior change, but uptake of testing still low with only 11% of men and 12% of women who have been tested for HIV and received their results (RDHS2005), waiting for the results of the RDHS2010; this is why the Ministry of Health started the PIT program. As a new program, it is important to understand how the program has been implemented and evaluate its effectiveness today and provides recommendations for changes. Purpose: The aim of this study was to assess the overall implementation of the PIT program as initiated by RBC/IHDPC/HIV Division (former TRAC) at all health centers supervised by Muhima Hospital for contributing to its improvement. Methods: This descriptive, cross sectional study conducted in 8 health centers supervised by Muhima district hospital concerns an overview of these 8 health centers by interviewing their heads, the implementation of PIT program by interviewing the 26 health care providers working in outpatient department and the quality of services receiving by the 260 patients coming for outpatient services by an exit interview done end of May and start of June 2011. A program monitoring framework (tracking inputs, process, outputs, outcomes and impact) was used to analyze the PIT program implementation. Routinely collected data from RBC/IHDPC/HIV Division (former TRAC) were used for the analysis. Findings: More inputs in the PIT program implementation have been put in place like avail the guideline, register, reporting tool, training manual, reporting system, funds for formative supervisions and health facilities personnel ,equipment, reagents. The trainings were conducted both on the quality of services and on the reporting system, but there still a need to emphasize also to the personnel working in OPD. The uptake of the HIV counseling and testing through PIT in OPD was 30% in February 2011. Conclusion: The PIT program has increased the coverage of HIV testing opportunities, and has increased the testing uptake. However there is a still to do more efforts in improving the quality of services received by the clients especially in pre-test counseling by more trainings and formative supervisions in all services particularly in OPD.