Paper short abstract:

To ensure that women who have given birth in health facilities are screened two strategies are implemented: The opt in and the opt out. The presentation aims at questioning these two strategies regarding the challenge of access to health care.

Paper long abstract:

The prevention of mother-to-child transmission remains a challenge for the health system in sub-Saharan Africa since the success of this program requires attendance at the structures of care by women during their pregnancy. In Cameroon, the North and far North regions are distinguished by low attendance at prenatal care by pregnant women. To get around this problem and to ensure that women who have given birth in health facilities have been screened the Ministry of public health has implemented two strategies for women whose HIV status is not known at the time of their birth. These strategies are applicable only in the delivery room. The opt in strategy refers to making an HIV screening in the delivery room after a written or an oral consent of the patient. Whereas the opt out strategy relies on an « implicit consent » of the labouring woman in the delivery room with the assumption that other biological screening such as complete blood counts, hepatitis serology, etc. are generally required.

This presentation aims at questioning these two strategies regarding the challenge of access to health care. This work is based on preliminary results of an ethnographic survey conducted from august to September 2012 in the North and the Far-North region. It is divided into two principal parts: firstly, the context of the implementation of these two strategies and secondly the ethical and deontological justification of caregivers as well as their practices.