scholarly journals Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034418
Author(s):  
Christina Lumbantoruan ◽  
Margaret Kelaher ◽  
Michelle Kermode ◽  
Endang Budihastuti
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Hiv Positive ◽  
Pmtct Programme ◽  
Cross Sectional ◽  
Hiv Epidemic ◽  
Mother To Child

ObjectivesDespite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.DesignA retrospective cross-sectional study in December 2017.SettingAll health facilities providing PMTCT programmes in Indonesia.ParticipantsAll health facilities registering at least one woman in antenatal care in 2017.InterventionPMTCT data extraction from the national reporting system on HIV/AIDS and government reports.OutcomesWomen retention in the PMTCT programme for at least 3 months and associated health facility characteristics.ResultsA total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).ConclusionsWe observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.

scholarly journals The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

2020 ◽  
Vol 14 (11.1) ◽  
pp. 122S-127S
Author(s):  
Maryana Sluzhynska ◽  
Olga Denisiuk ◽  
Ruzanna Grigoryan ◽  
Yulia Sereda ◽  
Gennadiy Slabkiy ◽  
...  
Keyword(s):  
Urban Areas ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Medical Doctor ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Mode Of Transmission ◽  
Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

scholarly journals Community-based assessment of infant feeding practices within a programme for prevention of mother-to-child HIV transmission in rural Zimbabwe

2006 ◽  
Vol 9 (5) ◽  
pp. 563-569 ◽  
Author(s):  
J Orne-Gliemann ◽  
T Mukotekwa ◽  
A Miller ◽  
F Perez ◽  
M Glenshaw ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Hiv Transmission ◽  
Health Workers ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Infant Feeding Practices ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Mother To Child ◽  
Hiv Negative

AbstractObjectiveTo describe the infant feeding practices and attitudes of women who used prevention of mother-to-child transmission of HIV (PMTCT) services in rural Zimbabwe.DesignA cross-sectional study including structured interviews and focus group discussions was conducted between June 2003 and February 2004.SettingThe study took place in Murambinda Mission Hospital (Buhera District, Manicaland Province), the first site offering PMTCT services in rural Zimbabwe.SubjectsThe interviews targeted HIV-infected and HIV-negative women who received prenatal HIV counselling and testing and minimal infant feeding counselling, and who delivered between 15 August 2001 and 15 February 2003. The focus groups were conducted among young and elderly men and women.ResultsOverall, 71 HIV-infected and 93 HIV-negative mothers were interviewed in clinics or at home. Most infants (97%) had ever been breast-fed. HIV-negative mothers introduced fluids/foods other than breast milk significantly sooner than HIV-infected mothers (median 4.0 vs. 6.0 months, P = 0.005). Infants born to HIV-negative mothers were weaned significantly later than HIV-exposed infants (median 19.0 vs. 6.0 months, P = 10−5). More than 90% of mothers reported that breast-feeding their infant was a personal decision, a third of whom also mentioned having taken into account health workers' messages.ConclusionThe HIV-infected mothers interviewed were gradually implementing infant feeding practices recommended in the context of HIV. Increased infant feeding support capacity in resource-limited rural populations is required, i.e. training of counselling staff, decentralised follow-up and weaning support.

scholarly journals Health professionals’ experiences and views on obstetric ultrasound in Vietnam: a regional, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031761
Author(s):  
Sophia Holmlund ◽  
Pham Thi Lan ◽  
Kristina Edvardsson ◽  
Ho Dang Phuc ◽  
Joseph Ntaganira ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Health Professionals ◽  
Rural Areas ◽  
Fetal Heart ◽  
Cross Sectional Study ◽  
Obstetric Ultrasound ◽  
Cross Sectional ◽  
Uncomplicated Pregnancy ◽  
Ultrasound Study

ObjectivesObstetric ultrasound is an important part of antenatal care in Vietnam, although there are great differences in access to antenatal care and ultrasound services across the country. The aim of this study was to explore Vietnamese health professionals’ experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.DesignA cross-sectional questionnaire study was performed as part of the CROss Country UltraSound study.SettingHealth facilities (n=29) in urban, semiurban and rural areas of Hanoi region in Vietnam.ParticipantsParticipants were 289 obstetricians/gynaecologists and 535 midwives.ResultsA majority (88%) of participants agreed that ‘every woman should undergo ultrasound examination’ during pregnancy to determine gestational age. Participants reported an average of six ultrasound examinations as medically indicated during an uncomplicated pregnancy. Access to ultrasound at participants’ workplaces was reported as always available regardless of health facility level. Most participants performing ultrasound reported high-level skills for fetal heart rate examination (70%), whereas few (23%) reported being skilled in examination of the anatomy of the fetal heart. Insufficient ultrasound training leading to suboptimal pregnancy management was reported by 37% of all participants. ‘Better quality of ultrasound machines’, ‘more physicians trained in ultrasound’ and ‘more training for health professionals currently performing ultrasound’ were reported as ways to improve the utilisation of ultrasound.ConclusionsObstetric ultrasound is used as an integral part of antenatal care at all selected health facility levels in the region of Hanoi, and access was reported as high. However, reports of insufficient ultrasound training resulting in suboptimal pregnancy management indicate a need for additional training of ultrasound operators to improve utilisation of ultrasound.

scholarly journals Clinical and Obstetric Risk Factors for Postnatal Depression in HIV Positive Women: A Cross Sectional Study in Health Facilities in Rural KwaZulu-Natal

2020 ◽  
Vol 17 (22) ◽  
pp. 8425
Author(s):  
Nontokozo Lilian Mbatha ◽  
Kebogile Elizabeth Mokwena ◽  
Sphiwe Madiba
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Postnatal Depression ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Hiv Positive ◽  
P Value ◽  
Cross Sectional ◽  
Hiv Positive Women

Postnatal depression (PND) remains underdiagnosed and undertreated in different socio-economic backgrounds in South Africa. This study determined the prevalence of and clinical and obstetric risk factors for PND symptoms among HIV positive women in health facilities in a rural health district in South Africa. The Edinburgh Postnatal Depression Scale was used to measure PND from 386 women who had delivered a live infant. More than half (58.5%) tested HIV positive during the current pregnancy. The prevalence of PND symptoms was 42.5%. Logistic regression analysis yielded significant associations between clinical and obstetric variables of pre-term baby (p-value < 0.01), baby health status p-value < 0.01), baby hospitalization, (p-value < 0.01), and knowing the baby’s HIV status (p-value = 0.047). Maternal variables associated with PND were level of education (p-value < 0.01), monthly income (p-value < 0.01), and source of income (p-value = 0.05). At multivariate analysis, none of the clinical and obstetrical risk factors were independently associated with the PND. The high prevalence of PND symptoms underscore the need to integrate routine screening for PND in prevention of mother to child transmission of HIV programmes to enable early diagnosing and treatment of PND.

scholarly journals Knowledge and utilization of prevention of mother-to-child transmission of HIV services among pregnant women in Tanzania

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Esther Ngadaya ◽  
Angela Shija ◽  
Calvin Sindato ◽  
Amos Kahwa ◽  
Godfather Kimaro ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cross Sectional ◽  
Correct Knowledge ◽  
Comprehensive Knowledge ◽  
Mother To Child ◽  
Hiv Negative

Background: Human Immunodeficiency Virus (HIV) infection among children is mainly vectored through mother-to-child transmission. Prevention of mother-to-child-transmission strategy is highly effective; however, its accessibility and utilization is affected by the lack of knowledge among other factors. Methods: A cross-sectional study was conducted among antenatal care attendees in two districts in Tanzania to determine their knowledge and utilization of the prevention of MTCT services. Results:  We interviewed 160 antenatal care attendees aged 18-45 years with a mean (SD) age of 30.4 (6.3) years; 74 (46.2 %) were HIV-infected. HIV-infected women demonstrated significantly correct knowledge of HIV (p=0.001) and AIDS (p=0.014) than uninfected individuals. HIV-infected women also significantly demonstrated correct knowledge of mother-to-child transmission during pregnancy than HIV-uninfected women (p=0.016) and during delivery (p=0.005). A significant proportion of HIV-positive women compared to HIV-negative women were aware that correct use of antiretroviral during pregnancy can reduce the risk of mother-to-child-transmission of HIV (p<0.039), but only 6 (3.75%) of all women were aware that correct use of antiretroviral during delivery can significantly reduce the risk of mother-to-child-transmission. HIV-infected women had significant comprehensive knowledge of HIV/AIDS (p=0.001) and prevention of mother-to-child transmission of HIV (p=0.006) than HIV-negative women. Comprehensive knowledge prevention of mother-to-child transmission of HIV was low among the study participants. Male partners’ involvement in maternal antenatal care was significantly higher among HIV-infected women than males from the HIV-infected women group (p<0.006). Conclusion: The study demonstrated inadequate knowledge of PMTCT among women who made ANC visits. HIV uninfected women had poorer knowledge compared to the HIV-infected ones. Routine HIV counseling and testing services were highly accepted among these women.

scholarly journals Implementation of maternal and perinatal deaths surveillance and response system among health facilities in Rural Tanzania: Analytical cross-sectional study

2021 ◽  
Author(s):  
Christina Kashililika ◽  
Fabiola Vincent Moshi
Keyword(s):  
Health Facility ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Perinatal Deaths ◽  
Rural Tanzania ◽  
Surveillance And Response ◽  
The Status ◽  
Bivariate Logistic Regression ◽  
Implementation Status

Abstract BackgroundMaternal and Perinatal Deaths Review and Surveillance (MPDSR) system when used effectively has the power to bring into reality, a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in rural settings of Tanzania.MethodThis study was conducted among 38 health facilities from three districts of Morogoro region, Tanzania from April 27, 2020 to May 29, 2020. Quantitative data was collected through document review for MPDSR implementation status. The outcome was determined by using special scoring sheet with a total 30 points. Facilities that scored 10 points or above were considered to have satisfactory status of MPDSR implementation while the facilities that scored below 10 points were considered to have unsatisfactory status of MPDSR implementation. Bivariate logistic regression analyses were used to determine the predictors of implementation status among health facilities.ResultsMajority of health facilities 20(52.6%) had satisfactory MPDSR implementation status. The predictors of MPDSR implementation in a facility were level of health facility [Hospital (AOR = 11.945 at 95% CI = 1.133 – 125.942, P = 0.039)] and ownership of the facility [Public (AOR = 0.133 at 95% CI = 0.019 – 0.920, P = 0.041)].ConclusionMPDSR implementation status among health facility is on average not satisfactory. More efforts are needed to raise the status of MPDSR implementation in the country so that the maximum benefit of MPDSR is obtained.

scholarly journals Readiness of health facilities in providing basic antenatal care laboratory test services and client satisfaction in Ethiopia

2021 ◽  
Author(s):  
Hailemariam Segni Abawollo ◽  
Ismael Ali Beshir ◽  
Zergu Tafesse Tsegaye ◽  
Binyam Fekadu Desta ◽  
Asfaw Adugna Guteta ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Laboratory Test ◽  
Pregnant Women ◽  
Human Resource ◽  
Client Satisfaction ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Laboratory Equipment ◽  
Cross Sectional ◽  
Satisfaction Rate

Abstract Background: To enable early identification of pregnancy-related health complications and other potential problems that affect the outcomes of pregnancy, pregnant women need to receive the basic laboratory test services during antenatal care. The provision of antenatal care laboratory test services is influenced by the availability and capacity of support systems.Methods: A health facility based cross-sectional study design was employed. Results: One hundred and ninety-nine facilities and 960 pregnant women were involved. Sixty-seven-point one percent of facilities had the minimum required infrastructure; the minimum required laboratory documents were present in 67.2% of facilities; the minimum laboratory equipment needed was present in 49.6% of facilities; and 76% of facilities had trained laboratory personnel who could provide basic antenatal care laboratory test services. The average stockout rate on the date of the visit was 29.6%; stockouts during the past thirty days was 32%; and the mean number of days that the available stocks last was for 93 days. The average availability of basic antenatal care laboratory test services in health facilities was 84% with infrastructure (p=0.018) and equipment (p=0.000) being the significant predictors of service availability. The satisfaction rate for overall laboratory test services provided in the health facilities was 83.2%. Conclusions: Readiness of health facilities to deliver basic antenatal care laboratory test services in terms of infrastructure, documents, equipment, reagents, and human resource was low but the client satisfaction rate was within an acceptable range. The gaps in infrastructure, documents, medical equipment, reagents, and human resource of facilities need to be addressed to ensure better laboratory test services.

scholarly journals Pregnant and Postpartum Women’s Experiences and Perspectives on the Acceptability and Feasibility of Copackaged Medicine for Antenatal Care and PMTCT in Lesotho

2015 ◽  
Vol 2015 ◽  
pp. 1-10
Author(s):  
Michelle M. Gill ◽  
Heather J. Hoffman ◽  
Appolinaire Tiam ◽  
Florence M. Mohai ◽  
Majoalane Mokone ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Hiv Positive Women ◽  
Related Service ◽  
Improved Design

Objective.To improve PMTCT and antenatal care-related service delivery, a pack with centrally prepackaged medicine was rolled out to all pregnant women in Lesotho in 2011. This study assessed acceptability and feasibility of this copackaging mechanism for drug delivery among pregnant and postpartum women.Methods.Acceptability and feasibility were assessed in a mixed method, cross-sectional study through structured interviews (SI) and semistructured interviews (SSI) conducted in 2012 and 2013.Results.290 HIV-negative women and 437 HIV-positive women (n=727) participated. Nearly all SI participants found prepackaged medicines acceptable, though modifications such as size reduction of the pack were suggested. Positive experiences included that the pack helped women take pills as instructed and contents promoted healthy pregnancies. Negative experiences included inadvertent pregnancy disclosure and discomfort carrying the pack in communities. Implementation was also feasible; 85.2% of SI participants reported adequate counseling time, though 37.8% felt pack use caused clinic delays. SSI participants reported improvement in service quality following pack introduction, due to more comprehensive counseling.Conclusions.A prepackaged drug delivery mechanism for ANC/PMTCT medicines was acceptable and feasible. Findings support continued use of this approach in Lesotho with improved design modifications to reflect the current PMTCT program of lifelong treatment for all HIV-positive pregnant women.

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