Abstract

A cross-sectional quantitative assessment was conducted to evaluate the quality of testing in 242 human immunodeficiency virus (HIV) testing and counselling (HTC) sites in 25 states including the Federal Capital Territory (FCT) in Nigeria. A checklist assessing eight different quality systems essentials (QSE) adapted from World Health Organization/African Regional Office (WHO/AFRO) laboratory strengthening checklist was used. From the total percentage score obtained, the quality status of sites were classified using a zero to five step rating, based on the WHO/AFRO quality improvement stepwise approach. The 242 sites assessed were public (81%) and private (19%) health facilities; 104(43%) were primary and 138 (57%) secondary facilities. Only one site was at Step 5. Approximately, 15% performed at Step 4, 22% at Step 3, 26.5% at Step 2, 22.5% at Step 1 and 15% at Step 0. For the QSEs, mean percentage score was highest (100%) for human resource and lowest for proficiency testing [21.54 (95% C.I; 17.33 to 25.76)].  Overall, the public facilities performed better than the private facilities so did the secondary compared to the primary. The findings suggest that the performance of HTC sites remains low despite adequate human resources. Routine assessments and more effort on mentoring for quality improvement is required.

Key words: External quality assessment, on-site evaluation, HTC sites, Nigeria.