Assessment of voluntary counseling and testing (VCT) services in Ekurhuleni Metropolitan Municipality

Abstract
Introduction: VCT services are a meaningful entry point to a continuum of care, in treatment and prevention of HIV/AIDS and related illnesses. Although VCT has been available at some sites across the country even before 2000, there have been very few studies conducted to evaluate its implementation at local municipality level. This study describes the status of VCT implementation in the Ekurhuleni Metropolitan Municipality between January 2004 and March 2007. Methods: Using a questionnaire, checklist and data collection sheet, data was collected between April - May 2007 in a sample of 14 VCT sites. These were government funded sites that included three hospitals, three community health centres, three clinics, three non governmental organisations and two hospices and were selected from all three service delivery regions in Ekurhuleni. Areas assessed were demographics of facility managers, staff and training, referral system, guidelines, supervision and support and VCT registers. Results: Over ninety percent of the VCT sites had closed areas for HIV counseling and testing. Majority of the VCT service providers were lay counselors (52.9%) and others were nurses, doctors, dieticians, social workers and health promoters. Most of the counselors had received both formal and in-service training. Almost all sites (92.8%, N=13) had the relevant guidelines in place and in-service training and use of checklist were methods used to ensure adherence to guidelines. The majority of the sites (71.4%, N=10) regularly evaluated the quality of counseling offered to clients through direct observation (50.0%), exit interviews (20.0%), self evaluation (10.0%) and combination of direct observation and interviews (20.0%). Close to two thirds of the sites (64.3%, N=9) were satisfied with supervision received from the district office. All the sites used a formal letter to refer clients to other outside facilities. There was no uniformity in the data elements of VCT registers across sites and the registers had many gaps. iv Conclusions: The VCT sites in this study had the necessary set up for the implementation of basic VCT services. However, because of the small sample size, this conclusion may not be true for the whole of Ekurhuleni. There needs to be improvement in VCT record keeping and data management in the sites. Further studies are needed to evaluate factors influencing uptake of VCT services.
Description
MPH, Faculty of Health Sciences, University of the Witwatersrand
Keywords
counselling, testing, voluntary, assessment
Citation
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