ABSTRACT:
Healthcare quality significantly influences Voluntary Counseling and Testing (VCT) utilization among pregnant women, yet this relationship remains inadequately understood in South-West Nigeria. This literature review examines the quality dimensions of healthcare services and their impact on VCT uptake among antenatal attendees. A systematic review of peer-reviewed literature (2008-2025) was conducted across PubMed, African Journals Online, and Google Scholar, yielding 58 studies meeting inclusion criteria. Healthcare quality encompasses technical competence, interpersonal relationships, accessibility, affordability, and safety. VCT utilization varies from 61-96% depending on facility type and accessibility. Key quality barriers include insufficient trained counselors, long waiting times (>3 hours), inadequate privacy, provider attitudes, and limited service integration. Multiple accessibility dimensions geographic (40% reduced completion if >5km away), financial (95% lack transport money), availability (counselor shortages), accommodation (complex procedures), and acceptability (80.8% stigma) significantly predict VCT completion. Healthcare quality improvements including dedicated counselor recruitment, reduced waiting times, enhanced privacy, provider training, and service integration increase VCT utilization by 31.7%. Findings reveal that quality of healthcare services and accessibility dimensions operate synergistically to influence VCT uptake. Recommendations include implementing quality improvement initiatives, strengthening facility infrastructure, enhancing provider training, establishing mobile outreach services, and addressing community stigma to improve VCT accessibility and utilization among pregnant women in South-West Nigeria.