Utilization of voluntary counseling and testing services by health care providers in Eastern province, Kenya
Muewa, Nelson Paul Mbithi
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Despite the many advancements made in health in the world, many countries continue to exhibit negative trends concerning the health of their people largely due to the AIDS pandemic. Voluntary counseling and HIV Testing (VCT) is an essential component of an effective response to the AIDS pandemic world wide. VCT services can serve as an entry point to HIV care and support. However, it has become increasingly apparent that workplace programmes on HIV have overlooked hospital workers even though they are too at risk of HIV infection both from occupational and non occupational factors. Although they are at risk of HIV infection very few health personnel are aware of their HIV status and quite a limited number of them have been able to seek Voluntary Counseling and Testing services. This study was therefore seeking to determine the factors that affect utilization of VCT services by health providers in Kenya. To achieve this, a cross – sectional study was carried out in Eastern Province of Kenya. The study was specifically carried out in three (3) hospitals and Eight (8) Rural Health Centers in Makueni County and other four (4) major Hospitals (Machakos, Kitui, Embu and Meru ) in different Counties in Eastern province . The study subjects were different cadres of medically trained health providers including Doctors, Nurses, Clinical Officers, VCT counselors and other technical paramedical staff. Data was collected by use of a semi – structured self administered questionnaire schedule. The questionnaire was administered to 403 study subjects. The data was analyzed using SPSS programme, correlation and chi- square were used to determine association between variables. The results indicated that only half (52.6%) of health providers had utilized VCT services, but 60 % of them had been tested for HIV, some of them out side VCT centers. VCT Counselors had utilized VCT services more than any other cadre with 94% of them having been tested at VCT centers, followed by doctors (65%). Paramedics had utilized VCT services least (41%). The factors that influence the utilization of VCT by health providers were found to be level of knowledge on VCT, attitudes and perceptions towards VCT, accessibility of VCT services, level of education, gender and cadre. Of those tested 66.1% were females and 54.5% males showing a significant difference between the two genders p. value <0.05 in VCT uptake. When analyzed statistically utilization of VCT services was also found to be significantly associated with the cadre of health providers with p. value <0.05. However, the level of education among the cadres did not show any significant effect to their VCT utilization, p.value >0.05). The study also found that those with high level of positive attitudes towards VCT utilization had a higher VCT uptake compared to those with lower level of positive attitudes. Those with higher knowledge on VCT also exhibited a higher rate VCT uptake than those with relatively low level of knowledge. The major barriers for VCT utilization among health workers found in the study were fear of stigma and discrimination, lack of confidentiality with services personnel and partner trust. In conclusion this study found gaps in knowledge on VCT and attitudes / perception towards VCT which needs to be addressed. In view of the above findings, it is recommended that, the Kenya Government develop a workplace program for Health care Providers to promote VCT uptake. Issues of HIV/AIDS fear, stigma and discrimination among Health Providers should be addressed by the Government and Health Partners. HCW need further training on HIV and VCT to bridge the gaps identified on knowledge in this study.