mother-to-child transmission of HIV in Cameroon and the effects of staff training: a survey in 70 rural health care facilities.

Early assessment of the implementation of a national programme for the prevention of mother-to-child transmission of HIV in Cameroon and the effects of staff training: a survey in 70 rural health care facilities. .

Labhardt and colleagues set out to assess the availability of equipment and the staff’s knowledge to prevent mother-to-child Transmission (PMTCT) in rural healthcare facilities recently covered by the national PMTCT programme in Cameroon. In eight districts inventories of antiviral drugs and HIV test kits were made on site, using a standardised check-list. Knowledge of HIV and PMTCT was evaluated with a multiple-choice questionnaire based on typical clinical PMTCT cases. Staff participated subsequently in a 2-day training on HIV and the Cameroon PMTCT guidelines. Immediately after training and after 7 months, retention of knowledge was tested with the same questions but in different order and layout. Sixty two peripheral nurse-led clinics and the eight district hospitals were assessed. Whereas all district hospitals presented complete equipment, only six of the peripheral clinics (10%) were equipped with both complete testing materials and a full set of drugs to provide PMTCT. Thirty six peripheral facilities (58%) possessed full equipment for HIV-testing and 8 (13%) stocked all PMTCT drugs. Of 137 nurses, 102 (74%) agreed to the two knowledge tests. Fewer than 66% knew that HIV-diagnosis requires positive results in two different types of rapid tests and only 19% chose the right recommendation on infant-feeding for HIV-positive mothers. Correct answers on drug regimens in different PMTCT settings varied from 25% to 56%. All percentages of correct answers improved greatly with training (P <>

Editors’ note: Cameroon has set an ambitious objective of increasing the proportion of pregnant women who have access to HIV counselling and testing services from 10% to 50% by 2010. This study, conducted four to eight months after HIV test kits and antiretroviral drugs were distributed to health districts, found inadequate supplies of materials and low levels of staff awareness and knowledge of proper procedures. A two-day training programme including case-based interactive discussions led to sustained improvement in assessment scores. Guaranteeing the flow of equipment to peripheral clinics and maintaining health care worker competence through training and supportive supervision, will be key if Cameroon is to meet its 2010 objective.