How PMTCT Services Have Been Organized in Guiglo Regional Hospital in Post-Election Period in Ivory Coast

Presenter: Bangaly Doumbouya, Aconda vs ci

Background: Ivorian post-election crisis in 2011 caused militaries conflicts in several cities, disturbing health activities. Guiglo, one of the important cities in the West of country, was located in conflict zone. The aim is to describe how provision of PMTCT services have been organized in Regional Hospital (RH) in a context of war.

Methods:  This was a retrospective study reporting activities of PMTCT in Guiglo RH, from December 2010 to November 2011. Data was collected from the regional health office on: care provision in different steps of PMTCT, strategies for tracking and retaining  women and children in care, pre-test and post-test, ARV prophylaxis, lab pre-treatment screening  for HIV infected women and ARV treatment delivering.

Results:  In reporting period, 779 pregnant women came to 109 antenatal visits. 592 clients received HIV-C&T. Eighteen (18) of them were HIV+. Because of looting of laboratory during war, only 26% of HIV+ clients received pre-ARV biological test. Only 02/05 clients eligible for ARVs, obtained it. Due to difficulties in drug supply management and absence of medical staff related to insecurity, we noted high rate (40%) of loss to follow-up in the different steps of PMTCT. Only 61% of women received ARV prophylaxis for them and 42% for their children. For all clients who have recently given birth in maternity, only 1 child started ARV prophylaxis within 72 hours. In the same period one year before, the main indicators were much better. The strategy was to track at any point of care exposed and infected newborn for their PCR test.

Conclusions:  Political crisis in a country greatly weakens the health system. This study makes an assessment of 12 months in provision of PMTCT services in a hospital in West Africa, shows that environment of insecurity can negatively influence the quality of health services.