Paper Title
The Patient-Care Provider Relationship and its Influence on the Use of Services for the Prevention of Mother -to-Child Transmission of HIV: The Case of the Biyem-Assi District Hospital in Cameroon

Abstract
Mother-to-child transmission of HIV known as MTCT in sub-Saharan Africa, where infection continues to increase, remains a major public health problem, particularly in sub-Saharan Africa. In Cameroon, although the number of health facilities offering PMTCT services has increased since 2011 by 22.2%, the quality of services and the outcome of activities do not seem to have improved. Several obstacles are linked to the use of PMTCT services, including the quality of the patient-care provider relationship. The relationship a pregnant woman has with her care provider can influence her decisions about prenatal visits and therefore the quality of the relationship with the care provider. The purpose of this study is to contribute to the elimination of MTCT by improving the quality of the patient-care provider relationship and optimizing the use of PMTCT services in Cameroon. To achieve this, a cross-sectional study was conducted from April 07 to June 06, 2019 with 164 pregnant women consulting the PNC service, being at least at the third prenatal visit and women in immediate postpartum from the Biyem-Assi District Hospital. The objective was to assess the influence of the patient-care provider relationship on the use of PNC/PMTCT services through the scores of a PSR measurement scale. Univariate and bivariate descriptive analyses were performed using the SPSS TM software version 19.0. The PSR scores ranged from 15 to 56, and there is no statistically significant association between the score and HIV serostatus (p=0.942). However, the highest values of the PSR score were associated with positive responses regarding the cost of cheap prenatal visits (p=0.02), low waiting time (p=0.01). Similarly, there were very significant associations between satisfaction with information received in PNC and satisfaction with the availability of PNC services (p≤0,001). Comparing the averages between the PSR score and the identified components of PMTCT showed a highly significant association with access to HIV counseling and testing (p=0.008). The scale of the patient-care provider relationship is potentially useful, it is an instrument that could have an important role in the future relationship focused on improving PMTCT and reducing the risk of HIV infection in children. Keywords - Child Transmission, HIV infection, Patient-care relationship, Prenatal consultation