Outline
-
Abstract information
Title page/presenter information
Background
Rationale
Methodology
Results
Conclusion
Abstract Information
Session Title: Key populations: innovative implementation
Session Date: Tuesday, 1 December 2015
Session Time: 16:45 - 18:15
Session Room: Jacaranda 3
Abstract no: A-751-0003-00860
Assessing HTC and STI consultation service
delivery for key populations in Nigeria
through a mystery client survey
(TUAC0604)
IKANI, Samuel Ojonugwa [M.Sc, B.Sc.]
Participant Number: 925
Background
Access to sexual and reproductive healthcare services for key
populations is critical for lessening the spread of HIV. Findings from
researches also show that provision of HCT, early diagnosis and
treatment of STIs, can contribute to reducing the spread of HIV. In
Nigeria as well as in most sub-Saharan African countries, key
populations are highly stigmatized within the general population and
subliminally in the provision of healthcare services at health facilities.
Rationale
Health seeking behaviours by key populations is likely to improve if they are
satisfied with the quality of services received at health facilities. This will imply
their willingness to revisit such facility and most importantly refer other members
of the key population for similar services. Efforts has been made by the USAID
funded Strengthening HIV Prevention Services for MARPs project in Nigeria to
build capacities of healthcare providers in selected health facilities, in the project
states to offer non-stigmatized health care services to key populations. However,
very limited evidence exist to indicate the quality of services offered by these
trained providers to the members of key population.
Methodology
 Data for this study was collected by Mystery clients who are key population
 314 of over 7,500 members of the key populations on the prevention programme were
recruited and trained for the study and their composition were: Female Sex Workers =
109(35%), Persons who Inject drugs = 101(32%) & Men who have sex with men =
104(33%)
 These mystery clients visited selected health facilities on a scheduled date with the
intention of either obtaining HIV counselling and testing or STI consultation services.
After receiving any of these services, they completed a structured questionnaire,
documenting their experiences with the healthcare providers.
 The survey was conducted 12 of 37 states in Nigeria where the USAID-SHiPS project
was implemented in 2014. 33 public & private health facilities were purposefully
selected across the 12 states. These facilities were selected, as they are referral centers
for the project.
 Ethical approval for this study was obtained from Nigeria Institute of Medical Research
(NIMR) with IRB number 12201.
Results (1/1)
• Only 301 completed questionnaires were returned. These questionnaires were then
coded and analysed using SPSS V 20.
• About 85% of the respondents reported that the health facilities visited were easily
accessible and found operations time from Mondays to Fridays convenient.
• Posters, pamphlets and other health communication materials were visible to about
50% of respondents but only about a third believed the materials addressed their
needs and concerns indicating many of the facilities have communications targeted
at the general population.
• Although a good majority (71%) reported that they were counseled in separate
rooms, confidentiality of interactions could not be guaranteed or was compromised
as 50% of the respondents believed that their conversation could be overheard by
others around
Results (1/2)
• A little over half were assured of confidentiality of the counselling session; and less
than a fifth were asked to use a number, pseudonym or another name to ensure
confidentiality.
• Only about 50% of the mystery clients who accessed STI consultation adjudged the
providers to be friendly, welcoming, and non-judgmental after they self-identified
as an FSW, MSM or IDU.
• About 56% reported that the providers explored the use of condoms in multiple and
concurrent sexual relationships while 39% reported that the healthcare counseled
on partner reduction
• A little above 45% reported that healthcare provider discussed to need to adhere to
drugs while treating the STIs
• 62.6% of the mystery clients were referred by providers to other facility
Conclusion
Critical issues from this study are:
1. Poor information exchange between providers and their clients.
2. Providers did not firmly follow the National HTC and STI protocols for eliciting
required information that should inform their interactions with clients, particularly
on assuring and ensuring confidentiality.
3. There is a need to provide communication materials that are key population
specific at health facilities
4. It vital to strengthen health workers training programme to offer more satisfactory
health services to members of the key populations in Nigeria.
Thank you for Listening