scholarly journals Accessing Barriers and Determinants of Prevention of Mother to Child Transmission (PMTCT) of Human Immune Deficiency Virus (HIV) Services at Public Teaching Hospitals in Enugu State, Nigeria

2019 ◽  
pp. 1-9
Author(s):  
Umeobieri Ancilla Kate ◽  
Aniwada Elias Chikee ◽  
Obi Emmanuel Ikechukwu ◽  
Agunwa Chuka
Keyword(s):  
Waiting Time ◽  
Health Workers ◽  
Human Immune Deficiency Virus ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Household Chores ◽  
Stigma And Discrimination ◽  
Access Barrier ◽  
Enugu State ◽  
Mother To Child

Introduction: The most effective means of reducing Mother-to-Child transmission of HIV is to provide suppressive HAART. Prevention of Mother to Child Transmission (PMTCT) directly affects the achievement of Sustainable Development goals just. The unmet need for PMTCT services in Nigeria, particularly in Enugu state, is unacceptably high. This study aimed to assess factors associated with access barriers and determinants to PMTCT services in public health facilities in Enugu, Nigeria. Materials and Methods: The study design was a facility-based analytical cross-sectional study. HIV positive nursing mothers who were accessing PMTCT services were studied. Questionnaire was used. Chi-square test and Binary logistic regression was done to for determinants of experience of any access barrier.  Level of significance was determined at a p-value of ≤ 0.05. Results: A total of 2275 participants were reported on. A higher proportion of participants were in 30-34 years age group 124 (45.1%), attained secondary education 144(52.4%) and provided for by their husbands 174(63.3%) The major barriers identified were; long waiting time at the facility 184(66.9%), distance of facility 161(58.5%), PMTCT being far away from other units/departments 155(56.4%), Health workers talking to the clients with no respect 151(54.9%), Stigma and discrimination from friends/neighbours 163(59.3%) and from health workers 123(44.7%) as well as being too busy with household chores 130(47.3%). There were statistically significant association between experience of barriers with age in categories (χ2=11.741, p =0.008), religion (χ2=5.381, p =0.020), source of income (χ2= 8.817, p=0.032) and ethnicity (χ2=9.240, p=0.026). Conclusion: Over ninety percent of respondents experienced a form of barrier. The major barriers include; long waiting time, distance to facility, location of PMTCT units, Health workers attitude, Stigma and discrimination from health workers as well as being too busy with household chores. There was no identified predictor of access barrier.

Young Women’s Knowledge and Utilization of Prevention of Mother-to-Child Transmission (PMTCT) of HIV Services: Is There Any Relationship?

2012 ◽  
Vol 2 (3) ◽  
pp. 163-172
Author(s):  
Sadandaula R. Muheriwa ◽  
Angela Chimwaza ◽  
Alfred Maluwa ◽  
Martha Kamanga
Keyword(s):  
Hiv Transmission ◽  
Health Workers ◽  
Monitoring And Evaluation ◽  
Hiv Positive ◽  
Hiv Education ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Major Barrier ◽  
Behavior Change Interventions ◽  
Mother To Child

PURPOSE:To determine knowledge and practices of young women on utilization of prevention of mother-to-child transmission (PMTCT) of HIVservices.DESIGN:A cross-section descriptive study that used quantitative and qualitative data analysis methodologies.FINDINGS:Knowledge of PMTCT of HIV among respondents was universal. All respondents (100%,N= 184) stated that utilization of PMTCT services reduces transmission of HIV from mother to child. Respondents knew that HIV transmission can be reduced with exclusive breastfeeding (93%,n= 172), abrupt weaning at 6 months (44%,n= 81), taking single-dose nevirapine (SD-NVP; 43%,n= 79), and giving NVP to the baby (65%,n= 120). Very few respondents (4%,n= 7) stated that avoiding pregnancy is one way of preventing HIV transmission and that a mother who is HIV positive who has received SD-NVP or antiretroviral (ARV) therapy can still deliver a baby who is HIV positive. Actual practice was very low; only 14% breastfed exclusively and only 3% weaned their babies abruptly. Although all the 184 mothers were given NVP to take at onset of labor, very few respondents (22%) took NVP as recommended. Although it was recommended that all babies take NVP at birth and within 72 hr of birth, only 58% of the babies received NVP as recommended and only 3% of the women avoided pregnancy.CONCLUSION:There was a big discrepancy between knowledge and practice of PMTCT services. Culture was the major barrier because traditionally, babies are expected to be breastfed and supplements are fed to babies, too. Most mothers did not adhere to the taking of NVP at onset of labor. Therefore, there is a need to mobilize communities on PMTCT of HIV. The HIV education programmes should emphasize behavior-change interventions and should focus on both men and women, their partners, and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that knowledge is put into practice.

scholarly journals Enablers, Constraints and Extent of Implementation of the Elimination of Mother-to-child Transmission of HIV Policy Guidelines in Lira district; Application of a Policy Implementation Barometer

2020 ◽  
Author(s):  
Noel Namuhani ◽  
Hamiliton Kainga ◽  
Olufemi Obafemi ◽  
Adeyemi Adelabu ◽  
Moses Mukuru ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Health Facility ◽  
Qualitative Data ◽  
Health Workers ◽  
Antenatal Clinic ◽  
Health Coverage ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cross Sectional ◽  
Mother To Child

Abstract Background; Despite the adoption of Elimination of mother to child transmission (EMTCT) strategy in 2012, mother to child transmission of HIV remains one of the significant forms of new HIV infections among children in Uganda, accounting for 20% of new infections. However, the implementation of the EMTCT strategy in Uganda remains unclear and an under researched field. This study aimed at assessing the extent of implementation of EMTCT strategy, barriers and constraints in Lira district using the adapted Policy Implementation Barometer (PIB) approach. Methods; This was a cross sectional study that employed both quantitative and qualitative data collection methods. A Policy Implementation Barometer tool developed by a project called Supporting Policy Engagement for Evidence-based Decisions (SPEED) for Universal Health Coverage in Uganda was adopted to assess the extent of implementation of EMTCT strategy. A total of 32 interviews with health facility managers were purposively conducted from a random sample of 20 health facilities offering Antenatal clinic (ANC) services in Lira district. Quantitative data was analyzed using STATA 14. Qualitative data was analyzed using thematic content analysis approach. Results; Majority 17/32 (53.1%) of the respondents were health facility in charges, 14/32 (43.8%) were midwives and half 16/32 (50.0%) had been in service for more than five years. Half of the respondents perceived their facilities to have fully established programs for implementing EMTCT and only 2/32 (6.2%) perceived the EMTCT programs to be functioning optimally. The perceived level of EMTCT implementation was 80%. Almost all the respondents perceived the funding for EMTCT activities to be inadequate, untimely, and not sustainable. Only 4/32 (12.5%) of the respondents believed that the health workforce size was adequate to support EMTCT activities, 13/32 (40.6%) believed that health workers lacked the skills to provide EMTCT services.Conclusion/Recommendation; Overall, the perceived extent of EMTCT policy implementation was high, however slow progress was reported in some of the key policy objectives due to a number of hindrances including inadequate staff and funding. Therefore, there is a need for strategies to increase the number of health workers for EMTCT and solicit for more funding for the implementation of EMTCT strategy.

scholarly journals A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Adebola Adedimeji ◽  
Nareen Abboud ◽  
Behailu Merdekios ◽  
Miriam Shiferaw
Keyword(s):  
Health System ◽  
Pregnant Women ◽  
Health Workers ◽  
Contextual Factors ◽  
Sub Saharan Africa ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Utilization Of Services ◽  
System Factors ◽  
Mother To Child

Objectives. Despite the availability of services to prevent mother-to-child transmission (PMTCT) of HIV, socio-cultural, health system and operational factors constrain many pregnant women from accessing services or returning for followup thereby increasing the risk of vertical transmission of HIV to newborns. We highlight and describe unique contextual factors contributing to low utilization of PMTCT services in Arba-Minch, Ethiopia. Methods. Qualitative research design was utilized to obtain data through focus group discussions and in-depth interviews with antenatal clinic attendees, health workers health facilities in the study area. Results. Awareness of PMTCT services and knowledge of its benefits was nearly universal, although socioeconomic, cultural and health system factors, including stigma and desire to prevent knowledge of serostatus, impede access to and utilization of services. Health system factors—lack of appropriate followup mechanisms, inadequate access to ARV drugs and poorly equipped manpower also contribute to low utilization of services. Conclusion. Reducing mother-to-child transmission of HIV in sub-Saharan Africa will be more effective when unique contextual factors are identified and addressed. Effectiveness of PMTCT interventions rests on a well functioning health system that recognize the importance of social, economic, cultural contexts that HIV positive pregnant women live in.

scholarly journals Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia

2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Flavia Strato Shayo ◽  
Bob Mash
Keyword(s):  
Hiv Transmission ◽  
Health Workers ◽  
Hiv Infections ◽  
Coordination Of Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Paediatric Hiv ◽  
Modifiable Factors ◽  
Mother To Child

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.

scholarly journals Tantangan Pelaksanaan Program Prevention Of Mother To Child Transmission (PMTCT): Systematic Review

2019 ◽  
Vol 4 (1) ◽  
pp. 55 ◽  
Author(s):  
Nimas Ayu Lestari Nurjanah ◽  
Tri Yunis Miko Wahyono
Keyword(s):  
Systematic Review ◽  
Health Workers ◽  
Active Role ◽  
Hiv Treatment ◽  
Pmtct Program ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Lack Of Information ◽  
Mother To Child ◽  
Hiv Aids

Background: HIV / AIDS is still a global health problem which needs to be addressed including prevention of HIV / AIDS transmission from mother to child. Prevention of transmission is carried out by implementing the Prevention of Mother to Child Transmission or PMTCT program. The PMTCT program is considered successful in reducing the risk of mother-to-child transmission, but this has not been done well and thoroughly, various kinds of challenges have occurred in the implementation of the PMTCT program.Objective: To know the challenges that occur in implementing the PMTCT programMethod: This study uses a systematic review based on Preferred Reporting Items For Systematic Reviews & Meta-Analyzes (PRISMA)  to identify all the literature published using relevant keywords.Results: challenges in implementing the PMTCT program are the lack of information on HIV treatment, lack of family support, the heavy workload experienced by health workers and the limited availability of HIV testing equipment and drug stocks.Conclusion:  The success of efforts to prevent HIV / AIDS transmission from mother to child does not depend on one party only, but involves several parties, the active role of health workers in providing education and information about HIV / AIDS to mothers and their families is not enough but must be added with active roles and support from family members to HIV mothers as the primary motivator for good behavior in accordance with the guidelines for PMTCT.

scholarly journals Progress and Challenges of Implementing Decentralized HIV Testing For Prevention of Mother-to-Child Transmission of HIV – Myanmar

2019 ◽  
Vol 8 (1) ◽  
pp. 44-53
Author(s):  
San Hone ◽  
Li Li ◽  
Sung-Jae Lee ◽  
W. Scott Comulada ◽  
Roger Detels
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Service Providers ◽  
Point Of Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Stigma And Discrimination ◽  
Testing Uptake ◽  
Mother To Child

Background: Myanmar has adopted point-of-care (POC) HIV testing for its prevention of mother-to-child transmission of HIV program, and was initiated in 84 townships in 2013. This study assessed the progress of HIV testing uptake from 2012, one year prior to POC testing, to 2015, and the challenges faced by service providers during the rapid rollout of this testing strategy. Methods: This serial cross-sectional study included 23 townships randomly selected from the 84 townships. An open-question survey was used to collect information on the challenges faced by service providers. A random effects logistic model was used for assessing the progress of HIV testing uptake among urban and rural health center groups. Results: HIV testing uptake for antenatal care (ANC) attendees increased from 60% to 90% for rural and from 70% to 90% for urban attendees. The proportion of ANC attendees who were tested at their first visit increased from 70% to 80% for rural and from 70% to 90% for urban attendees. In addition, the proportion receiving same-day test results increased from less than 10% to 90% for both groups. Major challenges faced during the initial rollout included low health awareness among pregnant women, fear of stigma and discrimination, long travel times and costs, and increased workloads of providers in rural settings. Conclusions and Global Health Implications: The program should consider recruiting local volunteers to help reduce the workloads of service providers. Professional education based on need and continued mentoring and quality control schemes for HIV testing need to be in place. This decentralized strategy would be applicable to other resource-limited countries. Key words:  • HIV/AIDS • Pregnant Women • Point-of-Care (POC) HIV Testing • Antenatal Care (ANC) • Prevention of Mother-to-Child Transmission of HIV (PMCT) • Service Cascade • Stigma and Discrimination   Copyright © 2019 Hone et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV (Preprint)

2017 ◽  
Author(s):  
Sheana Bull ◽  
Deborah SK Thomas ◽  
Elias C Nyanza ◽  
Sospatro E Ngallaba
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Health Workers ◽  
Activity Level ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pilot Intervention ◽  
Mother To Child ◽  
Antenatal Visits

BACKGROUND The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. OBJECTIVE The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. METHODS We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. RESULTS Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. CONCLUSIONS T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV.

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