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 Integrating the prevention of mother-to-child transmission of HIV after AIDS denialism in South Africa: Perspectives of experts and health care workers - A qualitative study

2020 ◽  
Author(s):  
Jean Claude MUTABAZI ◽  
Corie Gray ◽  
Lorrein Muhwava ◽  
Helen Trottier ◽  
Lisa Jayne Ware ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Services ◽  
Health System ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Aids Denialism ◽  
Mother To Child

Abstract Background Integrating vertical programmes into routine health services under complex socio-political and health system conditions is a priority and a challenge. The successful rollout of Prevention of Mother-to-Child Transmission programmes (PMTCT) in sub-Saharan Africa has decreased Human Immunodeficiency Virus (HIV), reduced child mortality and improved maternal health. In South Africa, PMTCT is now integrated into existing health services and this experience could serve as a relevant example for integrating other programmes into comprehensive primary care. We explored the perspectives of both experts and frontline health workers (FHCWs) in South Africa on PMTCT integration into primary health care (PHC) in the context of post-AIDS denialism using a Complex Adaptive Systems framework. Methods We conducted a total of 20 in-depth semi-structured interviews; 10 with experts (PMTCT and health system experts, policymakers, researchers and activists) and 10 with FHCWs including clinic managers, nurses and midwives. All interviews were conducted in person, audio-recorded and transcribed. Three investigators collaborated in coding transcripts and used an iterative approach for thematic analysis. Results Experts and FHCWs agreed on the importance of integrated PMTCT services. Experts reported a slow and partial integration of PMTCT programs into PHC following its initial rollout as a stand-alone program in the aftermath of the AIDS denialism period. Experts and FHCWs diverged on the challenges associated with integration of PMTCT. Experts highlighted bureaucracy, HIV stigma and discrimination and a shortage of training for staff as major barriers to PMTCT integration. In comparison, FHCWs emphasized high workloads, staff turnover and infrastructure issues (such as lack of rooms, small spaces, etc.) as their main challenges to integration. Both experts and FHCWs suggested that working with community health workers, particularly in the post-partum period, helped to address cases of loss to follow-up of women and their babies and to improve linkages to protein-chain reaction (PCR) testing and immunisation. Conclusions Despite organised efforts in South Africa, experts and FHCWs reported multiple barriers for the full integration of PMTCT programmes in PHC, especially postpartum. Our results suggest opportunities to address operational challenges towards more integrated PMTCT and other health services in order to improve maternal and child health.

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.

Prevention of Mother-to-Child Transmission of HIV – an Update from Rural Africa

Praxis ◽  
2019 ◽  
Vol 108 (15) ◽  
pp. 977-981
Author(s):  
Ezekiel Luoga ◽  
Anna Gamell
Keyword(s):  
Pregnant Women ◽  
Sub Saharan Africa ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Treatment Access ◽  
Missed Opportunities ◽  
Innovative Strategies ◽  
Women Living With Hiv ◽  
Sub Saharan ◽  
Mother To Child

Abstract. Sub-Saharan Africa is home of 85 % of pregnant women living with HIV and 90 % of HIV-infected children. WHO issued the first prevention of mother-to-child transmission of HIV (PMTCT) recommendations in 2000. These guidelines have been revised to incorporate new evidence and align with the goal of universal treatment access and zero infections among children. Currently, 82 % of HIV-infected pregnant women receive antiretroviral treatment, and infections among children have halved since 2010. However, in 2018, 160,000 children became infected. Reasons hindering the success of PMTCT are: a) non-universal HIV testing during pregnancy; b) low retention through the PMTCT cascade; and c) missed opportunities to diagnose women who acquire HIV while pregnant or breastfeeding. To address these gaps innovative strategies are needed.

scholarly journals Programme recommendations for the prevention of mother-to-child transmission of HIV: A practical guide for managers

2003 ◽  
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Sub Saharan Africa ◽  
Maternal Child Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Working Paper ◽  
Sub Saharan ◽  
Mother To Child ◽  
Prevention Of Hiv

UNAIDS estimates that 800,000 children were infected with HIV in 2001, almost all through transmission of the virus from their mothers during pregnancy, childbirth, or breastfeeding. Of these, seven of each eight live in sub-Saharan Africa and most of the rest live in South and Southeast Asia. To combat mother-to-child transmission of HIV (MTCT), in 1999 the UNAIDS Secretariat, UNFPA, UNICEF, and WHO launched the Inter Agency Task Team on Prevention of HIV Transmission in Pregnant Women, Mothers, and Their Children (IATT), which provides guidance for prevention of MTCT (PMTCT). In the view of the IATT, PMTCT is part of broader strategies to prevent the transmission of HIV and sexually transmitted diseases, to care for HIV-positive women and their families, and to promote maternal-child health. The IATT has proposed a four-pronged approach for the prevention of HIV transmission to pregnant women, mothers, and their children, yet significant financial and technical challenges remain. To address these challenges, UNICEF has supported 11 pilot projects in Africa, Asia, and Latin America. This HIV/AIDS working paper provides guidance for improving and scaling up PMTCT programs, based on what program managers and evaluators identify as successful strategies.

Community Based HIV Screening in Pregnant Women and Provision of Prevention of Mother to Child Transmission Care in Rural Zambia

2017 ◽  
Vol 1 (8) ◽  
Author(s):  
Mary Shilalukey Ngoma ◽  
Tepa Nkumbula ◽  
Wilbroad Mutale ◽  
Chabala Chishala ◽  
Reuben Mbewe ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Screening ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Community Based ◽  
Rural Zambia ◽  
Mother To Child

scholarly journals Does facility readiness promote high-quality of provider-initiated HIV testing and counseling to pregnant women? A national survey for improving policy of prevention of mother-to-child transmission of HIV in Tanzania

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Deogratius Bintabara ◽  
Athanase Lilungulu ◽  
Shakilu Jumanne ◽  
Mzee M. Nassoro ◽  
Bonaventura C. Mpondo
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
High Quality ◽  
Hiv Testing And Counseling ◽  
Mother To Child ◽  
Facility Readiness ◽  
Testing And Counseling

Abstract Background Provider-initiated HIV testing and counseling (PITC) is a recommended approach to screen for HIV to all pregnant women during antenatal care (ANC) visits, and all with HIV positive results have to be enrolled into prevention of mother-to-child transmission of HIV (PMTCT) program. However, little is known about the relationship between facility readiness and the uptake of PITC to pregnant women attending ANC in Tanzania. Therefore, this study assessed whether the facility readiness promotes the uptake of PITC to the pregnant women attending ANC for the purpose of improving the PMTCT interventions in Tanzania. Methods This study analyzed data for health facilities obtained from the 2014–2015 Tanzania service provision assessment survey. The Primary outcome measure was a composite variable (with score of 0–5) in which its higher scores indicates provision of high-quality of PITC. Also, facilities scored higher in the PMTCT service readiness index were considered to have high readiness to provide PMTCT services. In Poisson regression analyses, a series of models were fitted to assess whether there is an association between provision of high-quality of PITC and facility readiness. In all statistical analysis, a P < 0.05 was considered significant. Results Out of 1853 included first-visit ANC consultations, only about one-third of pregnant women received all five components required for PITC. The mean percentage of PMTCT readiness score was moderate 63.96 [61.32–66.59]%. In adjusted model, we found that facility with high readiness to provide PMTCT services was significantly associated with the provision of high-quality of PITC (model 2: [β = 0.075, P = 0.00]). Conclusion In order to increase high-quality of PITC services, efforts should be made to improve the PMTCT facility readiness by increasing availability of trained staffs, diagnostic tools, and ARTs among health facilities in Tanzania.

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