scholarly journals Preventing Mother-To-Child Transmission of HIV in Benin City, Edo State, Nigeria: The Health Workers’ Perspective

Author(s):  
Temitope Ashipa ◽  
Antoinette Ngozi Ofili

Introduction: Mother-to-child transmission of HIV threatens the survival of children of below five years of age. Health workers play an important role in preventing mother-to-child transmission of HIV. Objective: The objective of this study was to evaluate the programme for preventing mother-to-child transmission of HIV (PMTCT) in Benin City, Edo State from the perspective of the health workers involved in the programme. Methodology: This was a qualitative study evaluating the PMTCT programme in Benin City from the perspective of health workers and PMTCT programme officers. Data was collected through key informant interviews held with health workers at seven health facilities providing comprehensive PMTCT services. Key informant interviews were also held with government officials supervising the PMTCT programme in the state. Results: Fifteen key informant interviews were conducted with health workers and PMTCT programme officers in the state. The key informants had been involved in the PMTCT programme for between three years and eight years. The respondents identified several benefits of the PMTCT programme during the course of the study. The benefits included reduction in stigmatisation, improved quality of life for HIV positive mothers and reduction in mother-to-child transmission of HIV. Several challenges to the implementation of the programme were identified by the respondents including inadequate manpower, stock-outs of antiretroviral medications and patients’ preference for home deliveries. Recommendations to overcome these challenges included increased programme funding, training and re-training of health workers, sustained mass media campaigns to reduce stigmatisation of persons living with HIV among others. Conclusion: The health workers were generally positive in their perception of the programme for preventing mother-to-child transmission of HIV in Benin City, Edo State as the programme had provided numerous benefits for the patients, the community in addition to upgrading existing health facilities. Factors hindering the implementation of the programme from the health workers’ perspective were staff shortages, inadequate supply of drugs and other commodities and poor adherence by patients. Achieving the goal of reducing mother-to-child transmission of HIV in Benin City and Nigeria as a whole requires combined efforts by all stakeholders including patients, health workers, members of the community, non-governmental organisations and the various tiers of government.

2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Flavia Strato Shayo ◽  
Bob Mash

Background: Ending new paediatric HIV infections continues to be a global health priority. Cuba and other countries have demonstrated that elimination of mother-to-child transmission is possible through Prevention of Mother-to-Child Transmission (PMTCT) interventions. As Namibia works on improving PMTCT there is a need to identify the local modifiable factors to achieve zero new HIV infections.Aim: This study aimed to identify the modifiable factors within the PMTCT programme, which contributed to the acquisition of HIV infection among children.Setting: The study was carried out in the Onandjokwe District, Northern Namibia.Methods: A descriptive audit was undertaken of 59 medical records of mothers and their children under two years, who acquired HIV despite the PMTCT programme between 2014 and 2016.Results: The study found that overall HIV transmission was only 2%, but 80% of the paediatric HIV infections could be prevented by implementing the existing Namibian PMTCT recommendations. Overall 61% of modifiable factors were related to mothers, 30% to health workers and 10% to the health system. The top three modifiable factors were the mother defaulting on ART during pregnancy or breastfeeding, the health worker not intervening when the mother failed the first-line ART regimen, and poor coordination of care between the hospital and primary care.Conclusion: Although overall transmission is low with the PMTCT programme, the majority of remaining HIV infections among children under two years could be prevented by addressing the modifiable factors identified in this study.


2017 ◽  
Vol 11 (1) ◽  
pp. 36-44
Author(s):  
Refilwe Ramoshaba ◽  
Sello Levy Sithole

Background:The pandemic of Human Immunodeficiency Virus (HIV) is the most severe health challenge affecting children across the world. It is estimated that more than 90% of all HIV infections in children result from Mother-to-Child Transmission (MTCT). Poor knowledge and awareness of MTCT and Prevention of Mother-to-Child Transmission (PMTCT) among HIV positive mothers and their babies is a major setback to the success of the PMTCT programmes.Methods:A qualitative approach and a cross-sectional design were applied in this study. The sample size of the study was 26 participants. Purposive sampling was used to select HIV infected mothers enrolled for PMTCT follow-up services and health care providers responsible for the implementation of the PMTCT programmes. In-depth interviews were conducted with fifteen HIV infected mothers at two health facilities. Two Focus Group Discussions (FGDs) were conducted with eleven health workers at the two health facilities. Focus groups comprised of six participants from Mankweng Clinic and five participants from Mankweng Gateway Clinic.Results:The findings from the study reveal that the majority of the respondents were aware of MTCT, but lacked knowledge and understanding about how a mother can transmit HIV to her child during pregnancy, labour and breastfeeding. The majority of the participants did not understand the risk of MTCT after birth and failed to mention breastfeeding as a mode of transmission. However, most of the participants were aware that MTCT can be prevented. The respondents were aware of the importance of treatment adherence as a prevention measure to avoid MTCT.Conclusion:Based on these findings, a number of recommendations were made. The first is that educational and awareness programmes need to be developed or strengthened on health risks. Mass campaign media should provide information on the importance of PMTCT activities through the use of community radio stations, Television, newsletters, bill boards etc. People need to know more about PMTCT activities, health personnel need continuous training to provide clear information on PMTCT activities.


2009 ◽  
Vol 10 (4) ◽  
pp. 12
Author(s):  
Ashraf Hassen Coovadia ◽  
Ameena Ebrahim Goga ◽  
Laurie Schowalter

The Prevention of Mother to Child Transmission of HIV (PMTCT)programme is a critical intervention to reduce the incidence of paediatric HIV infections . It is also a key intervention to decrease infant, child and maternal mortality. The optimal implementation of a sound, evidence-based PMTCT programme is essential to meet both the HIV reduction targets in the National Strategic Plan1 and to achieve Millennium Development Goals(MDGs) 4 (reducing infant and child mortality) and 5 (reducing maternal mortalty).2 Since 2001, South Africa has been implementing a programme to prevent mother-to-child transmission of HIV. Since 2007, national PMTCT policy has evolved into a strong, enabling framework that should reduce vertical transmission significantly. This paper reviews the milestone studies that have contributed to our knowledge about drug regimens to reduce MTCT (mother-to-child transmission of HIV), reviews the latest South African PMTCT guidelines and the possible future changes. Strengthened / revised drug regimens for PMTCT are, essential but insufficient for measureable decreases in HIV transmission and improvements in maternal and childl health. The main challenge is implementation. Until the enhanced PMTCT policy is effectively operationalised, measureable achievements will remain elusive.


2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Barbara A. Hanrahan ◽  
Adri Williams

Background: When new guidelines for existing programmes are introduced, it is often the clinicians tasked with the execution of the guidelines who bear the brunt of the changes. Frequently their opinions are not sought. In this study, the researcher interviewed registered nurses working in the field of the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) to gain an understanding of their perspectives on the changes introduced to the guidelines. The guideline changes in 2014 were to move from the World Health Organization (WHO) Option B to Option B + which prescribes lifelong antiretroviral therapy (ART) for all HIV-positive pregnant women regardless of CD4 cell count.Objective: To determine what the registered nurses’ perspectives are on the PMTCT programme as implemented at four PHC facilities in the Limpopo Province.Method: For this qualitative investigation, a descriptive research design was implemented. The data were collected during semi-structured interviews with nurses from four primary healthcare facilities in the Limpopo Province of South Africa. Data were analysed using thematic analysis.Results: Challenges preventing effective implementation (e.g. increased workloads, viz. staff shortages; poor planning of training; equipment and medication shortages and long lead times; poor patient education) were identified.Conclusion: In spite of the successes of the PMTCT programme, considerable challenges still prevail; lack of patient education, poor facilities management and staff shortages could potentially influence the implementation of the PMTCT guidelines negatively.


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