Sep 2 , 2023

A significant drop in providing HIV tests has been recorded in health care during pregnancy follow-ups across the country, according to a report released by the Ethiopian Public Health Institute (EPHI) two weeks ago.

The report indicates that although a third quarter of health facilities nationwide offer antenatal care (ANC) services, only 36pc are capable of diagnosing HIV compared to the previous research in 2014.

The latest Ethiopia Service Provision Assessment (ESPA) report is done by experts from the Institution in partnership with the Ministry of Health financed by the federal government and USAID.

Data was collected from 1,407 health facilities for six months assessing their capacity and potential to provide quality maternal and newborn care, adequate family planning, and sexually transmitted and non-communicable disease treatments.

Fikeresilasie Getachew, a national survey coordinator of the report, indicated that private health institutions massively contributed to the declined rate observed where only 42pc test for HIV.

"Most of them claim not to have testing kits or capacity," he said.

Management at the Ethiopian Pharmaceuticals Supply Service (EPSS) argues otherwise. Solomon Nigussie, the deputy director general asserted that they have six months of stock.

According to him, over 60pc of the 7.8 million HIV testing kits procured last year have been distributed nationwide. They are expecting 12.5 million kits in the fiscal year from Global Fund.

He indicated the type was changed a year ago to enhance the efficiency to 99pc while the algorithm was changed to testing three times.

"We revised the amount of kits given to health facilities based on the number of positive results," he said. "But maternity care is an exception."

This is done to 'properly' use the given kits and further address the more positive result-recording centres rather than 'wasting' the kits in low-reporting facilities.

According to the recent report on EPHI, the prevalence of HIV cases is estimated to be over half a million people while 7,194 new infections were detected in 2023.

Antenatal care promotes positive outcomes by preventing complications during pregnancy, delivery and the postpartum period. The service should include at least four focused visits suggesting a  minimum of eight contacts.

During the follow-up, basic physical examination, preventive interventions (including HIV tests) and counselling focused on nutrition, progress and delivery plans.

Complications of pregnancy and childbirth are among the leading causes of death among women. In 2017, 12,000 maternal death was recorded, according to the Ministry of Health.

Betsegah Mothers' and Children's Hospital is one of the known obstetrics centres in the capital established in 2004. The Admin Ayenew Melese estimates a monthly follow-up for 3,000 expectant mothers and 150-200 deliveries.

He observed fluctuations in the testing kit delivery this year after the hospital was included under Kirkos District from Bole District nearly two months ago. According to Ayenew, the new administration has relaxed the delivery schedule with no kits inflow for a month.

"We're sending them to test for HIV in other health facilities for now," said Ayenew.

Out of the 600,000 tests across the capital 8,956 cases were found to be positive for HIV. Officials at the Health Bureau disclosed directing procedures for testing individuals with a high-risk potential.

Seife Demissie, director of pharmaceutical supply & service directorate in Addis Abeba Health Bureau. "Our testing procedures have changed into testing potentially risked individuals only," he said. The risky individuals are people who were engaged in unprotected sexual intercourse, in contact with blood and sharp things and sex workers.

Officials at the Ministry observed a decline in service quality. Kedir Seid (MD), strategic affairs executive officer at the Ministry of Health, said the assessment duration is extended due to the COVID-19 pandemic, the national security situation and the process of securing a budget from a donor.

"This requires further understanding of the reasons," Kedir told Fortune.

Last week USAID and the Ministry launched a 49.8 million dollar project on Quality Healthcare project to fight the causes of maternal and child mortality.

Addis Abeba recorded an average of 1.5pc of the total positive results while private clinics reported 0.3pc with most of the cases reported in walk-in centres focused on HIV transmission recording 3.1 pc positive results.

Experts believe the awareness level has plummeted arguing that the public should be encouraged to check for HIV rather than limit the kit. Naod Firdu (MD) is a public health expert at Addis Abeba University. He argues that the kits are far from expensive with most funded from non-governmental organisations.

"The positive yield will increase after testing the general public," he told Fortune.

PUBLISHED ON Sep 02,2023 [ VOL 24 , NO 1218]

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