Pattern of Prevention-of-Mother-to-Child-Transmission Service by Private Hospitals In Makurdi Nigeria

Nigeria has the highest number of new HIV infections worldwide and Benue State was reported to have the highest HIV Prevalence in the country. These may partly be due to low coverage of Prevention-of-Mother-to-child-transmission services in private hospitals. Prevention-of-Mother-to-Child-Transmission outlets are concentrated in public facilities but many people patronize private hospitals. This study assessed Prevention-of-Mother-to-Child-Transmission Service provision by private hospitals in Makurdi. A Cross sectional survey of 12 (private-for-profit) registered hospitals with facilities for antenatal and delivery care was carried out. Information was obtained using structured questionnaires. All hospitals performed HIV testing. Six (50%) routinely counseled all pregnant women for testing.  Eight (66.7%) offered Prevention-of-Mother-to-Child-Transmission Services. Four (33.3%) had staff trained in Prevention-of-Mother-to-Child-Transmission but one hospital where only midwives were trained did not provide Prevention-of-Mother-to-Child-Transmission Services. Five (41.7%) of the hospitals gave antiretroviral prophylaxis, none had facilities for CD4 count or viral load.  A total of 4(50%) of the facilities provided care for infants but only one collected samples for early infant diagnosis.  Service delivery appeared to be influenced by cost and staff training. Gaps in service delivery included lack of routine HIV testing, inadequate ARV prophylaxis, inadequate care and support to infants and family members, limited laboratory capacity and use of obstetric procedures which could increase transmission. Private health facilities need support from governments and international partners. Care must be taken to involve medical directors of hospitals in training, provide regular updates about protocols and linkages with other organizations offering services they lack.  This would increase service coverage, improve quality of services and source data on Prevention-of-Mother-to-Child-Transmission Services.