摘要：We assessed whether quality of maternal and newborn health services is influenced by presence of HIV programs at Kenyan health facilities using data from a national facility survey. Facilities that provided services to prevent mother-to-child HIV transmission had better prenatal and postnatal care inputs, such as infrastructure and supplies, and those providing antiretroviral therapy had better quality of prenatal and postnatal care processes. HIV-related programs may have benefits for quality of care for related services in the health system. In the past decade, the government of Kenya, with the support of international donors, has achieved a dramatic scale-up of HIV services, which has resulted in expanded coverage and a two thirds reduction in the number of AIDS-related deaths between 2002 and 2011. 1 However, although some studies have shown that targeted vertical HIV investments have a positive effect on other health services, others have shown a mixed effect, and few have focused on effect on quality. 2–5 Questions about quality of care for mothers and newborns are particularly important in Kenya, a country in which the maternal mortality ratio and newborn deaths are high. 6 Reducing maternal mortality requires that all women have access to emergency obstetric care to address complications during labor and delivery. 7 These complications, ranging from postpartum hemorrhage to birth asphyxia in the newborn, frequently cannot be predicted in advance but can be successfully managed if detected by trained clinicians with access to required medicines and supplies. 8–10 Quality of these services is critical to their success in saving lives. 11 In this study, we assessed whether the quality of maternal and newborn service inputs and processes was influenced by the presence of HIV programs at health facilities.
