Assessment of Health Facilities Delivering HIV Services among Patients in Bonny, South-South Nigeria

Background: The growing spread of HIV and AIDS among the people of Bonny Kingdom and capacity of medical facilities and service providers to respond to the dire situation have long posed public health concern of immeasurable proportion right from the inception of the Ibani-Se HIV/AIDS Baseline Survey Initiative in 2006 to the implementation of a three-year (2008-2011) intervention programme and thereafter. The impact of the provision of ART and other medical services related to HIV on the quality of care and satisfaction of all, HIV and non-HIV patients is unknown, and any available evidence is limited and arguable. The survey sought to know the number of health facility in the locality, the services they offer and most importantly the number of qualified personnel in such health facilities.

Methods: A standardized questionnaire was designed for facility assessment to measure the capacity of health facilities to undertake VCT and ART services. The survey was conducted in sixteen (16) health facilities; fourteen (14) public and two (2) private health facilities located within Bonny town and in the creeks. In each facility, the manager and health providers were surveyed, with at least one provider selected from the HIV/AIDS department; 10 randomly selected persons in the Outpatients Department/Unit including 5 from the HIV/AIDS services were interviewed. A standard health facility assessment checklist was developed to measure the quality of care, capacity of providers, developmental and training needs. Others included conformity to standard of practice and quality of medical equipment. Data was entered with Census and Survey Processing System (CSPro) and exported to SPSS or Stata for analysis.

Results: Of the sixteen health facilities, only seven provided both VCT and PMTCT services (Abalamabia health centre, Comprehensive health centre, NLNG RA Hospital, General Hospital, Finima health centre, Good shepherd Health medical lab and Chanel clinic) while one (Island Medical lab) provided VCT services; the others provided neither of the two services. Although, there are fairly adequate number and distribution of health facilities in the LGA, utilization of the general health services was found to have improved when compared to the previous survey. However, lack of structured unit for the provision of VCT and PMTCT services, specifically trained and designated counselors; and poorly motivated public healthcare providers have given rise to concerns about poor access of rural dwellers and inequitable distribution of the few available services, particularly to people most in need.

Conclusion: Implications of this survey were highlighted for a more effective HIV prevention and control programme for wide coverage.