Health Facility Characteristics and Their Relationship to Coverage of PMTCT of HIV Services across Four African Countries The PEARL Study 英文参考文献.docVIP

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Health Facility Characteristics and Their Relationship to Coverage of PMTCT of HIV Services across Four African Countries The PEARL Study 英文参考文献.doc

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Health Facility Characteristics and Their Relationship to Coverage of PMTCT of HIV Services across Four African Countries The PEARL Study 英文参考文献

HealthFacilityCharacteristicsandTheirRelationshipto CoverageofPMTCTofHIVServicesacrossFourAfrican Countries:ThePEARLStudy DidierK.Ekouevi1,2*,ElizabethStringer3,DavidCoetzee4,PiusTih5,TracyCreek6,KathrynStinson4, AndrewO.Westfall3,ThomasWelty1,2,NamwingaChintu3,BenjaminH.Chi3,CathyWilfert7 ,Nathan Shaffer8,JeffStringer3,FrancoisDabis2 1ProgrammePAC-CI,Abidjan,Coted’Ivoire,France,2InstituteNationaldelaSante′etdelaRechercheMe′dicale,Universite′VictorSegalen,Bordeaux,France,3Centrefor Infectious Disease Research in Zambia, Lusaka, Zambia, 4University of Cape Town, Cape Town, South Africa, 5Cameroon Baptist Health Convention Health Board, Bamenda, Cameroon, 6United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States, 7Elizabeth Glaser Pediatric AIDS Foundation, Washington,D.C.,UnitedStatesofAmerica,8WorldHealthOrganization,Geneva,Switzerland Abstract Background: Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT)coverageinsub-Saharanarepoorlyunderstood. Methodology/Principal Findings:WeconductedsurveysinhealthfacilitieswithactivePMTCTservicesinCameroon,Cote d’Ivoire,SouthAfrica,andZambia.Datawascompiledviadirectobservationandexitinterviews.Weconstructedcomposite scorestodescribeprovisionofPMTCTservicesacrossseventopicalareas:antenatalquality,PMTCTquality,suppliesavailable, patientsatisfaction,patientunderstanding ofmedication,andinfrastructurequality.Pearson correlationsandGeneralized Estimating Equations (GEE) to account for clustering of facilities within countries were used to evaluate the relationship between the composite scores, total time of visit and select individual variables with PMTCT coverage among women delivering. BetweenJuly2008andMay2009,wecollecteddatafrom32facilities;78%weremanagedbythegovernment healthsystem.Anopt-outapproachforHIVtestingwasusedin100%offacilitiesinZambia,63%inCameroon,andnonein Co?ted’IvoireorSouthAfrica.UsingPearsoncorrelations,PMTCT