scholarly journals THE OUTCOME OF PMTCT GUIDELINE IMPLEMENTATION TOWARDS THE PROGRAM PERFORMANCE FOR THE ELIMINATION OF HIV TRANSMISSION FROM MOTHER TO CHILD IN DENPASAR CITY

2021 ◽  
Vol 1 (1) ◽  
pp. 122-143
Author(s):  
Lely Wahyuniar
Keyword(s):  
Local Government ◽  
Human Resources ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Hiv And Aids ◽  
Health Centers ◽  
Pmtct Program ◽  
Primary Health ◽  
Hiv Test ◽  
Mother To Child

UNAIDS report on the level of HIV transmission from mother to child shows that Indonesia is in the highest rank in the world. This study aims to conduct rapid assessment about the full extent of PMTCT program and services in Denpasar City, Bali. This study located Denpasar City as a capital of Bali with high HIV cases and currently apply PMTCT services. The study conducted through FGDs, in-depth interview and observation in the primary health centers and hospitals. The data was validated by triangulating data from several sources. The results showed that the there is no specific local policy for PMTCT programs and services. There is no PMTCT program management guideline or SOP for PMTCT services at the Health Office and primary health centers. In Denpasar City there are already 5 primary health centers that provide comprehensive HIV and AIDS prevention and treatment services (LKB), and this includes providing PMTCT services consisting of HIV testing and ARV treatment for pregnant women. However, there is no ARV treatment for infant, this service must be obtained at general hospital through a referral mechanism. There is funding from local government (APBD) to buy diagnostic test for HIV and to capacity strengthening of human resources, but no support for further laboratory examinations. The empowerment for midwives to be involved in PMTCT program is limited, there has never been a comprehensive training on PMTCT and no empowerment of private practice midwives for PMTCT. The assistance’s activities to ensure ARV adherence is limited. There has been assistance for HIV positive mothers by NGOs in Denpasar City. Women with HIV still get stigma and discrimination from the community and health workers. There are also some challenges in data input, including error in inputting the data that need permission to edit it. It is recommended to improve: the HIV test coverage to 100% for pregnant women (for the first 90); the coverage and quality of ARV treatment (for the second 90); the capacity of PMTCT human resources; the commitment of local government; and data utilization.

scholarly journals Determinants of HIV provider-initiated testing and counseling screening service used by pregnant women  in primary health centers in Surabaya

2018 ◽  
Vol 26 (4) ◽  
pp. 293-301
Author(s):  
Samsriyaningsih Handayani ◽  
Susilowati Andajani ◽  
Lilik Djuari
Keyword(s):  
Pregnant Women ◽  
Service Use ◽  
Health Centers ◽  
Hiv Screening ◽  
Screening Service ◽  
Private Service ◽  
Self Confidence ◽  
Primary Health ◽  
Hiv Test ◽  
Logistic Regressions

Background: Offering free HIV screening service for pregnant women in primary health center in Surabaya has become obligatory since 2014, but only 70% used the service. Prior studies on HIV screening mostly focused on Voluntary Counseling and Testing.Methods: This was a cross-sectional study. Interviews were conducted with 150 pregnant women attending antenatal care in 1 of 9 public health centers (PHCs) in Surabaya and offered HIV screening within the same PHC. The eligibility criterium was pregnant women attending antenatal care in PHCs. The exclusion criteria were having been counseled for HIV prior to the interviews and/or experiencing an obstetric emergency. Using PRECEDE Framework with the concept of a comprehensive framework, this study focuses on identifying determinants of HIV PITC service use in PHCs in Surabaya. Binary logistic regressions and multiple binary logistic regressions were used in analyses.Results: The service use was associated with self-confidence of getting blood drawn for the test (p<0.001, adjusted OR=12.368, 95% CI=3.237–47.250) and past use of midwife private service for current pregnancy (p=0.029, adjusted OR=3.902, 95% CI=1.150–13.246). Self-confidence of getting blood drawn for HIV test mediated the effect of past use of midwife’s private service on HIV screening use.Conclusion: Past use of midwife’s private service affected self-confidence of getting blood drawn for HIV test on HIV screening use, and self-confidence affected the use of HIV PITC. This study results suggest that more midwives’ private practices are needed to increase the use of HIV PITC screening in PHC.

scholarly journals Prevention of HIV Transmission from Mother to Child: Challenges to the Successful Program Implementation and Practice in Indonesia

2021 ◽  
Vol 20 ◽  
pp. 232595822110407
Author(s):  
Kemal Nazaruddin Siregar ◽  
Laily Hanifah ◽  
Rikawarastuti ◽  
Lely Wahyuniar
Keyword(s):  
Pregnant Women ◽  
Program Implementation ◽  
System Analysis ◽  
Hiv Transmission ◽  
Health Workers ◽  
Group Discussion ◽  
Policy Implications ◽  
Local Policy ◽  
Hiv Test ◽  
Mother To Child

Introduction: The level of human immunodeficiency virus (HIV) transmission from mother to child in Indonesia ranks first worldwide. Newborn babies in Indonesia are at greater risk of experiencing the burden of HIV infection than babies born in other countries. Objectives: To explore the full extent of Prevention of Mother to Child Transmission (PMTCT) in South Sulawesi Province in 2020 and to discuss program and policy implications for PMTCT. Methods: This is a health system analysis study with a qualitative approach using focus group discussion, in-depth interviews, and observations in primary health centers and hospitals. Results: There is no local policy and guidelines for PMTCT programs and services; the coverage of HIV testing in pregnant women has not achieved 100% according to the target. There are limitations to human resources in public and private services to conduct the program. The assistance’s activities to ensure antiretroviral (ARV) adherence are limited, and HIV-positive women faced stigma and discrimination, not only from the community but also from health workers. Recommendations: Some recommendations are to improve the HIV test coverage to 100% in pregnant women as well as the coverage and quality of ARV treatment.

scholarly journals Private Midwives’ Perceptions on Barriers and Enabling Factors to Voluntary Counselling and HIV Test (VCT) in Bali, Indonesia

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Dinar Saurmauli Lubis ◽  
LPL Wulandari ◽  
Ni Luh Putu Suariyani ◽  
Kadek Tresna Adhi ◽  
Sari Andajani
Keyword(s):  
Pregnant Women ◽  
Thematic Analysis ◽  
Hiv Transmission ◽  
Institutional Barriers ◽  
Enabling Factors ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Hiv Test ◽  
Mother To Child ◽  
Depth Interviews

In Indonesia, more than half of pregnant women seek antenatal care (ANC) at private midwifery clinics. The midwives play an important role in advocating for voluntary counseling and testing (VCT) uptake among pregnant women during ANC. This study examined midwives’ perception of barriers and enabling factors with regards to refer pregnant women for HIV testing. The study was conducted in Denpasar City and Badung District, two localities in Bali with high HIV prevalence. Two focus groups discussions with 15 private midwives and five in-depth interviews were conducted. Data were transcribed verbatim and thematic analysis methods were used to examine patterns emerging from the data. Results showed that private midwives face personal barriers in the form of stigma as well as institutional barriers such as VCT operational hours that limit how and when they refer women for VCT. Barriers are strengthened by lack of support or reward from the health office. However, opportunities for integrated and comprehensive support systems within the health system and supportive social environment which would make it easy and rewarding for midwives to refer women to VCT clinics were seen as enabling factors. Increasing uptake of VCT is a necessity for eliminating mother to child HIV transmission. 

scholarly journals HUBUNGAN DUKUNGAN BIDAN DENGAN PEMERIKSAAN PMTCT (PREVENTION MOTHER TO CHILD TRANSMISSION) PADA IBU HAMIL DI PUSKESMAS KASIHAN II BANTUL

2020 ◽  
Vol 3 (1) ◽  
pp. 6-12
Author(s):  
Esitra Herfanda ◽  
Indah Pratiwi
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Health Care Facilities ◽  
Hiv And Aids ◽  
P Value ◽  
Mother To Child Transmission ◽  
Primary Health Center ◽  
Child Transmission ◽  
Primary Health ◽  
Mother To Child

HIV and AIDS transmission to infants can be prevented by comprehensive and effective PMTCT (Prevention Mother to Child Transmission) efforts in health care facilities. The role of the midwife in encouraging pregnant women to conduct PMTCT examinations is to provide support in the form of information, appreciation, instrumental and emotional information about HIV and AIDS thoroughly to the client until the client understands and gives the permission to conduct PMTCT examinations. The purpose of this study was to determine the correlation between midwife’s support and PMTCT examinations of pregnant women at Kasihan II Primary Health Center of Bantul. This research was conducted using observational analytic methods with cross sectional approach. Data collection techniques employed accidental sampling as many as 40 pregnant women as the respondents. The research instrument was a questionnaire with chi square as data analysis. The results of the study obtained showed that 80% among 40 respondents received good support, and 82.5% conducted PMTCT examinations. There was a correlation between midwife’s support and PMTCT examinations for pregnant women in Kasihan II Primary Health Center of Bantul with p value = 0.000 (p <0.05). Thus, it can be concluded that there was a correlation between midwife’s support and PMTCT examination for pregnant women at Kasihan II Primary Health Center of Bantul.   Keywords: Midwife, Support, PMTCT.

scholarly journals Integration of traditional birth attendants into prevention of mother-to-child transmission at primary health facilities in Kaduna, North-West Nigeria

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Reward O. Nsirim ◽  
Joseph A. Iyongo ◽  
Olayinka Adekugbe ◽  
Maureen Ugochuku
Keyword(s):  
Pregnant Women ◽  
Health Facilities ◽  
Traditional Birth Attendants ◽  
Health Centers ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
North West ◽  
Birth Attendants ◽  
Primary Health ◽  
Mother To Child

One of the fundamental challenges to implementing successful prevention of mother-tochild transmission (PMTCT) programs in Nigeria is the uptake of PMTCT services at health facilities. Several issues usually discourage many pregnant women from receiving antenatal care services at designated health facilities within their communities. The CRS Nigeria PMTCT Project funded by the Global Fund in its Round 9 Phase 1 in Nigeria, sought to increase demand for HIV counseling and testing services for pregnant women at 25 supported primary health centers (PHCs) in Kaduna State, North-West Nigeria by integrating traditional birth attendants (TBAs) across the communities where the PHCs were located into the project. Community dialogues were held with the TBAs, community leaders and women groups. These dialogues focused on modes of mother to child transmission of HIV and the need for TBAs to refer their clients to PHCs for testing. Subsequently, data on number of pregnant women who were counseled, tested and received results was collected on a monthly basis from the 25 facilities using the national HIV/AIDS tools. Prior to this integration, the average number of pregnant women that were counseled, tested and received results was 200 pregnant women across all the 25 health facilities monthly. After the integration of TBAs into the program, the number of pregnant women that were counseled, tested and received results kept increasing month after month up to an average of 1500 pregnant women per month across the 25 health facilities. TBAs can thus play a key role in improving service uptake and utilization for pregnant women at primary health centers in the community – especially in the context of HIV/AIDS. They thus need to be integrated, rather than alienated, from primary healthcare service delivery.

scholarly journals A Study on the Knowledge, Attitudes, and Behaviors of Pregnant Women Regarding HIV and Routine Rapid Testing: An Assessment in a High-Risk Marginal Area

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 793
Author(s):  
Leila Jahangiry ◽  
Zahra Aliyari ◽  
Koen Ponnet
Keyword(s):  
Hiv Prevention ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Health Centers ◽  
Local Health ◽  
Rapid Testing ◽  
Hiv Education ◽  
Attitudes And Behaviors ◽  
And Behaviors ◽  
Mother To Child

Acquired immunodeficiency syndrome (AIDS) is one of the main obstacles to communities’ development. The disease mostly involves active and productive population groups. This study aimed to determine the knowledge, attitudes, and behaviors of pregnant women regarding HIV prevention and rapid HIV tests. Pregnant women who were referred to the local health centers and who were willing to participate in the study were interviewed. To collect data, a standard questionnaire was used among 200 pregnant women in eight local health centers of Kermanshah, Iran. The survey contained 50 questions on demographic characteristics and the knowledge, attitudes, and behaviors regarding HIV/AIDS prevention and rapid tests for pregnant women. Although the majority (82.5%) of the pregnant women knew that mother-to-child HIV transmission during pregnancy was possible, fewer than half (48.2%) of them knew that HIV can be transmitted from mother to child through breastfeeding. Only 22.5% of pregnant women knew that a Cesarean section for HIV-positive mothers is recommended. The mean attitudes of pregnant women toward HIV prevention and HIV rapid testing were 4.5 (SD = 0.4) and 4 (SD = 0.3), respectively. Of the women, 11.5% had participated in an HIV rapid test counseling class, and 25.5% had participated in HIV education and counseling classes. The low knowledge of mothers regarding HIV transmission highlights the need for education and counseling classes and campaigns to improve knowledge and behaviors related to HIV prevention, especially during pregnancy for women in marginal regions.

scholarly journals Increasing Access and Adherence to the PMTCT Cascade: Is There a Role for Economic Strengthening Interventions?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Irina Yacobson ◽  
Morrisa Malkin ◽  
Elena Lebetkin
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Randomised Trial ◽  
Retention In Care ◽  
Economic Barriers ◽  
Research Questions ◽  
Women With Hiv ◽  
Mother To Child ◽  
Economic Strengthening ◽  
Pmtct Cascade

Interventions aimed at prevention of mother-to-child transmission (PMTCT) of HIV are extremely effective but remain underutilized in many countries. Common economic barriers to PMTCT experienced by pregnant women with HIV are well documented. Addressing these economic barriers has a potential to improve PMTCT utilization and further reduce mother-to-child HIV transmission. This review examines the evidence of the effects economic strengthening (ES) interventions have on use of and adherence to PMTCT and other health services relevant to PMTCT cascade. While very few studies on ES interventions were conducted in PMTCT settings, the results of a recent randomised trial demonstrate that conditional cash transfers offered to women in PMTCT programme can significantly improve retention in care and adherence to treatment. This review also considers evidence on ES interventions conducted within other health care settings relevant to PMTCT cascade. While the evidence from other settings is promising, it may not be fully applicable to PMTCT and more quality research on ES interventions among population of pregnant women with HIV is needed. Answering some of the research questions formulated by this review can provide more evidence for programme implementers and guide decisions about how to increase women’s use of and adherence to PMTCT services.

scholarly journals Female perspectives of male partners’ inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal

Curationis ◽  
2016 ◽  
Vol 39 (1) ◽  
Author(s):  
Mondli Miya ◽  
Tennyson Mgutshini
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
Child Health Services ◽  
Mother To Child Transmission ◽  
Male Partners ◽  
Child Transmission ◽  
Financial Investment ◽  
Mother To Child

Background: The South African government intervened by implementing the prevention of mother–to-child transmission programme (PMTCT) to curb the HIV transmission from mother to child during and after pregnancy. The PMTCT programme has been at the forefront of global prevention efforts since 1998. Without treatment, the risk of transmission ranges from one in five to one in two newborns; however, the risk of mother-to-child transmission can be reduced to as low as 2%–5% with evidenced interventions. Sub-Saharan Africa, and most particularly South Africa, is the most affected by the pandemic despite having the largest financial investment in PMTCT services across the continent.Objectives: The objectives of the study were to describe and explore the female perspectives of male inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal.Methodology: A qualitative, descriptive, explorative study was conducted through in-depth individual interview of pregnant women until data saturation.Results: The findings of the study revealed that the existing design of public hospitals was not wholly conducive to facilitating male inclusion in maternal and child health services. Resources were largely insufficient to support the participation of pregnant mothers and any attempts to support the inclusion of males needed to be based on a clear increase in service provision.Conclusion: The study recommended male partners’ inclusion in the prevention of mother- to-child HIV transmission to support effective management of HIV in pregnancy and PMTCT programmes. The inclusion of men will provide the holistic support needed by pregnant women on PMTCT programmes.

scholarly journals National-level effectiveness of ART to prevent early mother to child transmission of HIV in Namibia

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0233341
Author(s):  
Andrew Agabu ◽  
Andrew L. Baughman ◽  
Christa Fischer-Walker ◽  
Michael de Klerk ◽  
Nicholus Mutenda ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
National Level ◽  
Prevalence Ratio ◽  
Dried Blood Spots ◽  
Test Results ◽  
Hiv Diagnosis ◽  
Hiv Exposed Infants ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Mother To Child

Background Namibia introduced the prevention of mother to child HIV transmission (MTCT) program in 2002 and lifelong antiretroviral therapy (ART) for pregnant women (option B-plus) in 2013. We sought to quantify MTCT measured at 4–12 weeks post-delivery. Methods During Aug 2014-Feb 2015, we recruited a nationally representative sample of 1040 pairs of mother and infant aged 4–12 weeks at routine immunizations in 60 public health clinics using two stage sampling approach. Of these, 864 HIV exposed infants had DNA-PCR HIV test results available. We defined an HIV exposed infant if born to an HIV-positive mother with documented status or diagnosed at enrollment using rapid HIV tests. Dried Blood Spots samples from HIV exposed infants were tested for HIV. Interview data and laboratory results were collected on smartphones and uploaded to a central database. We measured MTCT prevalence at 4–12 weeks post-delivery and evaluated associations between infant HIV infection and maternal and infant characteristics including maternal treatment and infant prophylaxis. All statistical analyses accounted for the survey design. Results Based on the 864 HIV exposed infants with test results available, nationally weighted early MTCT measured at 4–12 weeks post-delivery was 1.74% (95% confidence interval (CI): 1.00%-3.01%). Overall, 62% of mothers started ART pre-conception, 33.6% during pregnancy, 1.2% post-delivery and 3.2% never received ART. Mothers who started ART before pregnancy and during pregnancy had low MTCT prevalence, 0.78% (95% CI: 0.31%-1.96%) and 0.98% (95% CI: 0.33%-2.91%), respectively. MTCT rose to 4.13% (95% CI: 0.54%-25.68%) when the mother started ART after delivery and to 11.62% (95% CI: 4.07%-28.96%) when she never received ART. The lowest MTCT of 0.76% (95% CI: 0.36% - 1.61%) was achieved when mother received ART and ARV prophylaxis within 72hrs for infant and highest 22.32% (95%CI: 2.78% -74.25%) when neither mother nor infant received ARVs. After adjusting for mother’s age, maternal ART (Prevalence Ratio (PR) = 0.10, 95% CI: 0.03–0.29) and infant ARV prophylaxis (PR = 0.32, 95% CI: 0.10–0.998) remained strong predictors of HIV transmission. Conclusion As of 2015, Namibia achieved MTCT of 1.74%, measured at 4–12 weeks post-delivery. Women already on ART pre-conception had the lowest prevalence of MTCT emphasizing the importance of early HIV diagnosis and treatment initiation before pregnancy. Studies are needed to measure MTCT and maternal HIV seroconversion during breastfeeding.

Antiretroviral Therapy in Pregnant Women

2019 ◽  
pp. 281-286
Author(s):  
William R. Short ◽  
Jason J. Schafer
Keyword(s):  
Clinical Trials ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Pediatric Aids ◽  
Women Living With Hiv ◽  
Pivotal Study ◽  
Aids Clinical Trials ◽  
Living With Hiv ◽  
Mother To Child ◽  
Over Time

Upon completion of this chapter, the reader should be able to describe the appropriate management of antiretrovirals for pregnant women living with HIV. Over time, research has demonstrated that proper prevention strategies and interventions during pregnancy, labor, and delivery can significantly reduce the rate of mother-to-child transmission (MTCT) of HIV. In 1994, a pivotal study in the field of HIV medicine, the Pediatric AIDS Clinical Trials Group 076, demonstrated that the use of zidovudine (ZDV) monotherapy during pregnancy substantially reduced the risk of HIV transmission to infants by 67% (...

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