Factors influencing the uptake of HIV voluntary counseling and testing in Namibia
Document type: mthesis
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Abstract:
Namibia is a big country with an estimated population of 2.1 million people living on a surface area of 824 000 km². The country has a generalized HIV epidemic with unprotected heterosexual contact as the main mode of HIV transmission. HIV prevalence in pregnant women was estimated at 17.8% in 2008. Voluntary counseling and testing (VCT) services is a key strategy in reaching universal coverage for prevention, care and support services. VCT became available since 2003 with the introduction of ART in public hospitals. VCT is available through integrated Primary Health Care Directorate (PHC) services and stand alone centers. The total number of people accessing VCT has increased from 4083 in 2003 to 178 926 in 2008. However, according to Namibia Democraphic and Health Survey (NDHS) (2006) only 50.9% women and 32% men have ever been tested. In addition, VCT uptake remains below the national target. The national target for VCT in 2008 was 275 000, of which 160 000 (58%) clients were counselled and tested. Of these only one third was men. The national target was based on feasibility rather than need. The aim of the study was to explore the factors that negatively affect the uptake of VCT. The study is based on analysis of the Namibian VCT data combined with literature review of VCT services in other African countries. The review was done systematically and two independent frameworks were used to analyse findings. One framework focuses on health service related factors based on the four dimensions of access; accessibility, availability, affordability and quality of care were added. The other framework was used to analyse individual, social and economic factors influencing VCT uptake. Men and young people under the age of 19 are less likely to be tested. Although there are many factors influencing VCT uptake, stigma, fear for positive HIV test, low risk perception and lack of access to health facilities offering VCT including same day test results and inconvenient opening hours were identified. Another constrain is the countries shortage of human resources to provide VCT services. To improve the uptake of VCT services, rapid HIV testing (same day results) should be made available to all facilities. Mobile VCT services should be made available at places where men are working and socializing. Youth friendly services are crucial to increase uptake in young people under the age of 19.
Authors:
Bock, M.E.
Country:
Namibia
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
HIV and AIDS
,
disease prevention and control
,
health services
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
vii, 47
Year:
2009
Region:
Southern Africa
Right:
© 2009 Bock
Subject:
Health and Nutrition
Title:
Factors influencing the uptake of HIV voluntary counseling and testing in Namibia
Training:
Master of Public Health / International Course in Health Development (ICHD)