scholarly journals Perceptions of mothers and healthcare professionals to contributors and preventions of loss-to-follow-up and child mortality at the PMTCT program after option B + guideline implementation in northwest Ethiopia

2020 ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Samuel T. Matula ◽  
Ayele Mamo ◽  
Ayelign Kassie ◽  
Biruk Abate

Abstract Background: The third United Nations Sustainable Development Goal includes a commitment to end HIV. In lined with the Sustainable Development Goal, Option B+ programs hold great promise for preventing transmission of HIV and moving towards an “AIDS-free generation. However, an estimated 110,000 AIDS-related deaths occurred among children in 2015. The Global Plan also identified Ethiopia as one of 22 high priority countries for improved prevention of mother to child HIV transmission services. But, there is a scarcity of data on the contributors of loss to follow up and mortality after option B+ guideline implementation in the Amhara regional state, Ethiopia. Methods: This study conducted in five zones of the Amhara regional state, Ethiopia. The study considers mothers that admitted to the 5-referral hospitals’ PMTCT departments, midwifery professionals who work in the respective hospital’s PMTCT departments, and HIV officers. The period for data collection was from March 21 to May 18/2019. An in-depth qualitative interview employed to gain access to the participants’ experiences and conducted an inductive qualitative content analysis.Results: Mothers, health professionals, and HIV officers were asked about the contributors of lost to follow up in the Amhara region. The participants’ suggestions on the causes categorized into a health facility, stigma and discrimination, and socioeconomic status themes. On the prevention of loss to follow up, the views of study participants were categorized into health facility improvement, psychosocial support, and loss to follow up retention mechanisms. On the causes of HIV related mortality, participants’ views categorized into vertical HIV transmission, carelessness of parents, and poor socioeconomic status themes. In the recommendations to prevent loss to follow up and mortality, participants forwarded their suggestions for health facilities and professionals and civic societies. On the prevention of mortality, participants’ views categorized into health care and mothers’ awareness.Conclusions: The participants were emphasizing the health facilities, health care professionals, and awareness of families to prevent loss to follow up and mortality among exposed infants after admission to the PMTCT program. Hence, concerned bodies mainly minister of health should outline on improving the service provided in the PMTCT department.

2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy and labour for various motives despite their unclear pharmacology and potential toxicity. Considering the United Nations Sustainable Development Goal (SDG) 3, exposure to herbs during pregnancy should be restricted in order to safeguard the health of mothers and newborns. This study aimed to assess the proportion of mothers using herbal medicines during pregnancy and delivery and to determine factors associated with the practice.Methods: This cross-sectional quantitative study gathered information from 340 mothers who delivered a live baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed mothers attending reproductive, maternal and child health clinics in Tabora, in central Tanzania. We compared proportions using chi-square test and performed a Poisson regression analysis to determine independent correlates of herbal use.Results: Over 60% of mothers in Tabora used herbal medicines during pregnancy and delivery. Major reasons for use were shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). Independent factors of herbal use were distance to the nearest health facility, adjusted prevalence ratio (aPR = 1.12, 95%CI = 1.00,1.25), perception of herbs as safe, (aPR = 1.16, 95%CI = 1.05,1.29) and health care providers’ stance on the use of herbs, (aPR = 1.14, 95%CI = 1.04,1.25).Conclusions: Use of herbal medicines during pregnancy and delivery in Tanzania is high. This calls for comprehensive investigations on the effects of herbs used during pregnancy and delivery as a step towards understanding contributions of forgotten exposures en route for achieving SDG 3. Additionally, health care providers ought to include health education messages during antenatal visits on the undesirable effects of using herbs.


Author(s):  
Samuel Mills ◽  
Jane Kim Lee ◽  
Bahie Mary Rassekh

Abstract A complete civil registration and vital statistics system is the best source of data for measuring most of the Sustainable Development Goal 3 indicators. However, civil registration does not include migration data, which are necessary for calculating the actual number of people living in a given area and their characteristics such as age and sex. This information is needed to facilitate planning, for example, for school places, health care, infrastructure, etc. It is also needed as the denominator for the calculation of a range of health and socioeconomic indicators. Obtaining and using these data can be particularly beneficial for measuring and achieving universal health coverage (Target 3.8), because civil registration can help to identify persons in need of health care and enable decision-makers to plan for the delivery of essential services to all persons in the country, including the most disadvantaged populations. By assigning unique identification numbers to individuals, for example, at birth registration, then using these numbers to link the individuals’ data from civil registration, national identification, and other functional registers, including registers for migration and health care, more accurate and disaggregated population values can be obtained. This is also a key to improving the effectiveness of and access to social services such as education, health, social welfare, and financial services. When civil registration system in a country is linked with its national identification system, it benefits both the government and its citizens. For the government, having reliable and up-to-date vital events information on its citizens supports making informed program and policy decisions, ensuring the accurate use of funds and monitoring of development programs at all levels. For individuals, it makes it easier to prove one’s identity and the occurrence of vital events to claim public services such as survivor benefits or child grants.


2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving the Sustainable Development Goal (SDG) 3: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. This study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed a Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 (61.2 %; 95%CI: 55.4, 66.3%) used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits (aPR:1.24; 95%CI: 1.02, 1.50, p=0.03). Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by the health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.


Author(s):  
Mesfin Wudu Kassaw ◽  
Ayele Mamo Abebe ◽  
Kenean Getaneh Tilaye ◽  
Gedefaw Diress ◽  
Mikiyas Amare Getu ◽  
...  

Abstract Background: Elimination of MTCT of HIV was a global public health priority. In 2013, the World Health Organization recommended antiretroviral therapy administration to all HIV positive pregnant, and breastfeeding women regardless of CD4 cell count or clinical stage, which is called “Option B+”. Ethiopia have had a high rate of MTCT of HIV. The rate of transmission on breastfeeding mothers was 24% in 2012. But the rate had been increased to more than 30% in 2015.Objective: This study aimed to determine outcomes of HIV exposed infants, explore the contributors of mortality and loss to follow up, and identify factors of HIV transmission among infants born from HIV positive mothers in Amhara regional state referral hospitals, Ethiopia, 2018/19. Methods: The study was done in five Amhara regional state referral hospitals’ PMTCT departments. A simple random sampling technique with proportional allocation was used to assess the outcomes of 217 exposed infants. A retrospective quantitative cohort design and qualitative exploratory design were used in all referral hospitals of the Amhara region. The data were collected from each hospital exposed infant medical record, which was documented between January 01/2014 and May 30/2017 . An in-depth interview was also taken place from health professionals working in the PMTCT department, zonal HIV officers, and mothers who are enrolled in the PMTCT department. A cumulative incidence rate was used to present mortality, transmission, and loss to follow- up.Results: The incidence rate of HIV transmission at enrollment to PMTCT program in Amhara regional state referral hospitals was 2.3% (95% CI, 0.5-4.6%), and 3.7 (95% CI, 1.4-6.5) at the time of completing PMTCT program using antibody or DNA-PCR test. Whereas the incidence rate of LTFU in Amhara regional state referral hospitals was 8.8% (95% CI, 5.4-12.4%). But the rate of mortality after enrollment to the program was zero. The interviewees’ opinions on mortality, and loss to follow up were categorized into themes.Conclusions: Irrespective of the WHO guideline expected outcome of option B+, the outcome of the PMTCT program in this study was high, particularly HIV transmission and LTFU.


2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving Sustainable Development Goal (SDG) 3, which states: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. Thus, this study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 [61.2 %; 95% confidence interval (CI): 55.4, 66.3%] used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits [adjusted Prevalence Ratio (aPR):1.24; 95%CI: 1.02, 1.50, p=0.03]. Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery among women in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.


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