1Management Sciences for Health Strengthening the gender focus to improve ANC/PMTCT service quality in Ethiopia Presenter: Nelia Matinhure Date: 3 July 2013 IMPACT NNPWE ANECCA DHEA EIFDDA EPHA Ethiopia Network for HIV/AIDS Treatment, Care & Support Program

2Management Sciences for Health Background and Results Background In Ethiopia, gender dynamics and health care provider attitudes contribute to barriers to accessing antenatal care and prevention of mother-to-child transmission. Study examined the needs and perceptions of 668 HIV-positive clients and 36 health care providers at 9 high patient load government health centers in Ethiopia’s Amhara and Tigray regions. Results Health center client and provider perceptions of key gender related issues were at times directly opposed. Health center management teams ranked as lowest priorities three key issues that HIV-positive clients considered important.

3Management Sciences for Health Issues HIV-positive clients considered important 1.HIV-positive women were counseled by their health care providers to not get pregnant without consulting them. They also reported that they were being counseled on PMTCT by mother mentors of their mother support group (MSG), which encouraged them to become pregnant. When they became pregnant, they reported being chided by their health care providers, which led to feelings of guilt and being stigmatized.

4Management Sciences for Health Issues HIV-positive clients considered important 2.ANC/PMTCT services were not male friendly as men were not allowed to witness the birth of their children despite health center invitation letters to men to accompany their spouses. 3.Participants preferred to link their ART appointments to market days, religious holidays, or other convenient times, which did not always coincide with health center opening hours. Recommendations Study underscores the importance of educating health care providers about their clients’ needs and equipping them with tools to improve services. Better integration of providers with mother support groups should be explored.

5Management Sciences for Health Ethiopia Network for HIV/AIDS Treatment, Care & Support Program IMPACT NNPWE ANECCA DHEAEIFDDAEPHA Thank you