WAITING TIME OF CLIENTS ACCESSING PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV/AIDS (PMTCT) IN LAGOS, NIGERIA

Abstract

Nigeria is currently contributing about 30% of the Global Mother to Child transmission of HIV (MTCT) burden; the largest proportion by any country probably due to poor delivery of health care service or coverage of the Prevention of mother to child transmission (PMTCT) program in the country. There is a high demand for ARVs which has been overwhelming in the few HlV clinics in the country resulting in overcrowding and long queues. Anecdotal evidence shows that patients arrive as early as 06.00 a.m to avoid missing the service and this raises a high suspicion of long waiting times which is likely to deter patients from continuing to receive ART services. The implication of this can lead to poor adherence to their treatment regimen leading to poor health outcomes for the patients. The aim of the study was to determine the length of time PMTCT clients' wait to access service in the Nigeria Institute of Medical Research (NIMR). It also identified the various procedures at the clinic, associated factors as well as possible operational problems that may lead to long waiting time of clients in health care facilities offering the PMTCT services. A descriptive cross sectional quantitative survey was undertaken using a time-delimited sample of PMTCT clients attending the NIMR HIV clinic over one month. Waiting time tracking instruments and questionnaires were used to collect data from PMTCT clients. Data were summarised using appropriate descriptive statistics and important hypothesis were tested using standard statistical tests of significance. The complete median waiting time was 131 minutes, higher than 70 minutes obtained from the clients' opinion of tolerable waiting time. The causes of the high patient waiting time were patients arrive earlier than staff at the service point (mismatch), lack of efficiency in time usage by staffs, patients arriving in more numbers than can be seen in an hour (batches) and logistics problems. It was also concluded that majority of the patients were satisfied with the attitudes of the personnel and the services in the facilities. However, it is recommended that the Clinic takes necessary steps to reduce the high patient waiting time at the PMTCT clinic.