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1
Kays, Megan, Godfrey Woelk, Tegan Callahan, Leila Katirayi, Michele Montandon, Felluna Chauwa, Anne Laterra, et al. "Evaluating the effect of a community score card among pregnant and breastfeeding women living with HIV in two districts in Malawi." PLOS ONE 16, no. 8 (August 11, 2021): e0255788. http://dx.doi.org/10.1371/journal.pone.0255788.
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Malawi faces challenges with retaining women in prevention of mother-to-child HIV transmission (PMTCT) services. We evaluated Cooperative for Assistance and Relief Everywhere, Inc. (CARE’s) community score card (CSC) in 11 purposively selected health facilities, assessing the effect on: (1) retention in PMTCT services, (2) uptake of early infant diagnosis (EID), (3) collective efficacy among clients, and (4) self-efficacy among health care workers (HCWs) in delivering quality services. The CSC is a participatory community approach. In this study, HCWs and PMTCT clients identified issues impacting PMTCT service quality and uptake and implemented actions for improvement. A mixed-methods, pre- and post-intervention design was used to evaluate the intervention. We abstracted routine clinical data on retention in PMTCT services for HIV-positive clients attending their first antenatal care visit and EID uptake for their infants for 8-month periods before and after implementation. To assess collective efficacy and self-efficacy, we administered questionnaires and conducted focus group discussions (FGDs) pre- and post-intervention with PMTCT clients recruited from CSC participants, and HCWs providing HIV care from facilities. Retention of HIV-positive women in PMTCT services at three and six months and EID uptake was not significantly different pre- and post-implementation. For the clients, the collective efficacy scale average improved significantly post-intervention, (p = 0.003). HCW self-efficacy scale average did not improve. Results from the FGDs highlighted a strengthened relationship between HCWs and PMTCT clients, with clients reporting increased satisfaction with services. However, the data indicated continued challenges with stigma and fear of disclosure. While CSC may foster mutual trust and respect between HCWs and PMTCT clients, we did not find it improved PMTCT retention or EID uptake within the short duration of the study period. More research is needed on ways to improve service quality and decrease stigmatized behaviors, such as HIV testing and treatment services, as well as the longer-term impacts of interventions like the CSC on clinical outcomes.
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John, Lugata, Nesister Odero, Jackson Nziku, and Bernard Njau. "Gap analysis between expectations and perceptions of pregnant women attending Prevention of Maternal to Child Transmission of HIV services in a private referral hospital in northern Tanzania: A cross-sectional descriptive study." PLOS ONE 16, no. 9 (September 22, 2021): e0257771. http://dx.doi.org/10.1371/journal.pone.0257771.
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Objective Pregnant women satisfaction with the Prevention of Mother-To-Child HIV Transmission services is an essential parameter in the determination of the quality of care and performance. This study aimed to measure the gap between pregnant women expectations of PMTCT services and perceptions of the actual PMTCT services and the relationship between their service gap scores and socio-demographic characteristics. Methods A cross-sectional descriptive study design was conducted from August to September 2020 on a sample of 105 participants. A pre-tested SERVIQUAL questionnaire was used to collect data and paired sample t-test, independent one-sample t-test, and one–way ANOVA was used to compare mean service gap scores. A p-value of < 0.05 was considered statistically significant. Results The overall mean gap score was (+ 0.31) indicating pregnant women perceived value of the quality of care of PMTCT services. The gap score in the 5 service dimensions was as follows: empathy (+0.49), tangibles (+0.43), assurance (+0.22), responsiveness (+0.20), and reliability (+0.19). Marital status (p-value 0.031) was the only social demographic characteristic associated with pregnant women service gap scores. Conclusion Overall, pregnant women perceptions of PMTCT services provided in the RCH clinic at KCMC were meet. Marital status was associated with the overall pregnant women service gap scores and perceived quality of care with PMTCT services. Pregnant women who were married had small service gap scores compared to either divorced or widowed or cohabiting women.
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Akal, Chalachew Genet, and Dessie Tegegne Afework. "Status of Prevention of Mother-to-Child Transmission (PMTCT) Services Utilization and Factors Affecting PMTCT Service Uptake by Pregnant Women Attending Antenatal Care Clinic in Selected Health Facilities of Afar Regional State, Ethiopia." Journal of Environmental and Public Health 2018 (December 12, 2018): 1–7. http://dx.doi.org/10.1155/2018/5127090.
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Mother-to-child transmission (MTCT) is the predominant way for children to acquire human immunodeficiency virus (HIV) infection worldwide including Ethiopia. Thus, objective of this study was to determine the status of prevention of mother-to-child transmission (PMTCT) services utilization and factors affecting PMTCT utilization in health facilities of Afar region, Ethiopia. A cross-sectional study was conducted from December 2014 to April 2015 taking 347 pregnant women and 22 health care providers. Data were collected using a questioner prepared separately for pregnant women and health care providers involved in PMTCT service delivery. Data were analyzed using SPSS considering P value <0.05 statistical significant. The study indicated that the PMTCT service utilization was 67.7%. The study also showed that there is statistically significant association in using PMTCT service with women education level, monthly income, and residence around PMTCT site. Though not statistically significant, excess waiting time, limited physical access to PMTCT sites, and transportation problem were identified as barriers for PMTCT service utilization by pregnant women. Though knowledge of mothers on MTCT of HIV and PMTCT service utilization in agropostural community of Afar region was promising, there were also different barriers identified hindering PMTCT utilization. Thus, we recommend “Wored” and zonal health office to create awareness on significance of PMTCT service in the community, enhance accessibility of PMTCT sites, provide up-to-date trainings for health care providers, and ensure constant supply for PMTCT service.
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Wahyuniar, Lely. "THE OUTCOME OF PMTCT GUIDELINE IMPLEMENTATION TOWARDS THE PROGRAM PERFORMANCE FOR THE ELIMINATION OF HIV TRANSMISSION FROM MOTHER TO CHILD IN DENPASAR CITY." International Seminar of Gender Equity Maternal and Child Health 1, no. 1 (July 8, 2021): 122–43. http://dx.doi.org/10.34305/gemic.v1i1.319.
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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.
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Ibobo, Judith A., Ezekiel Uba Nwose, and Helen Chime. "Reducing the mother-to-child transmission of HIV: findings from an early infant diagnosis program in Delta state Nigeria." International Journal Of Community Medicine And Public Health 4, no. 12 (November 23, 2017): 4352. http://dx.doi.org/10.18203/2394-6040.ijcmph20175085.
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Background: Mother-to-child transmission (MTCT) of HIV has been a global issue being addressed with prevention of mother to child transmission (PMTCT) strategy. Nigeria is said to be responsible for 30% of the global burden of MTCT of HIV. Hence, Delta state of Nigeria had implemented its own PMTCT in line with the global plan to eliminate MTCT. This paper evaluates the determinants and level of effectives of PMTCT with a view to develop a framework to review the program in Delta state.Methods: This was a narrative literature review which aimed at appraising available reports on PMTCT services and related data. In particular, the ‘Delta state development performance: health sector report 1991–2013’ was appraised. Results: Generally, Delta state has improved on infant survival better than national baseline. Specifically, on PMTCT, more women (average 2.9%) than men (average 2.1%) have tested positive for HIV in the 5 years period of 2008–2012 free screening. Further, the report indicates that the State has achieved 78% of eligible facilities offering PMTCT services in the state, but only 23% coverage of pregnancies. Conclusions: In the context of cost effectiveness as well as improvement in service delivery, there is a need to investigate the success rates of health facilities that are offering PMTCT services. There is also need to investigate the barriers to PMTCT that may be prevailing in Delta state.
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Chingombe, Innocent, Munyaradzi P. Mapingure, Shirish Balachandra, Tendayi N. Chipango, Fiona Gambanga, Angela Mushavi, Tsitsi Apollo, et al. "Patient costs for prevention of mother-to-child HIV transmission and antiretroviral therapy services in public health facilities in Zimbabwe." PLOS ONE 16, no. 8 (August 18, 2021): e0256291. http://dx.doi.org/10.1371/journal.pone.0256291.
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Zimbabwe has made large strides in addressing HIV. To ensure a continued robust response, a clear understanding of costs associated with its HIV program is critical. We conducted a cross-sectional evaluation in 2017 to estimate the annual average patient cost for accessing Prevention of Mother-To-Child Transmission (PMTCT) services (through antenatal care) and Antiretroviral Treatment (ART) services in Zimbabwe. Twenty sites representing different types of public health facilities in Zimbabwe were included. Data on patient costs were collected through in-person interviews with 414 ART and 424 PMTCT adult patients and through telephone interviews with 38 ART and 47 PMTCT adult patients who had missed their last appointment. The mean and median annual patient costs were examined overall and by service type for all participants and for those who paid any cost. Potential patient costs related to time lost were calculated by multiplying the total time to access services (travel time, waiting time, and clinic visit duration) by potential earnings (US$75 per month assuming 8 hours per day and 5 days per week). Mean annual patient costs for accessing services for the participants was US$20.00 [standard deviation (SD) = US$80.42, median = US$6.00, range = US$0.00–US$12,18.00] for PMTCT and US$18.73 (SD = US$58.54, median = US$8.00, range = US$0.00–US$ 908.00) for ART patients. The mean annual direct medical costs for PMTCT and ART were US$9.78 (SD = US$78.58, median = US$0.00, range = US$0.00–US$ 90) and US$7.49 (SD = US$60.00, median = US$0.00) while mean annual direct non-medical cost for US$10.23 (SD = US$17.35, median = US$4.00) and US$11.23 (SD = US$25.22, median = US$6.00, range = US$0.00–US$ 360.00). The PMTCT and ART costs per visit based on time lost were US$3.53 (US$1.13 to US$8.69) and US$3.43 (US$1.14 to US$8.53), respectively. The mean annual patient costs per person for PMTCT and ART in this evaluation will impact household income since PMTCT and ART services in Zimbabwe are supposed to be free.
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Nkhoma, Nicola, Linda Alinane Nyondo-Mipando, Chandra Makanjee, Nellie Dominica Myburgh, and Peter Suwirakwenda Nyasulu. "“What Will I Be Doing There Among So Many Women?”: Perceptions on Male Support in Prevention of Mother to Child Services in Lilongwe, Malawi." Global Pediatric Health 6 (January 2019): 2333794X1986544. http://dx.doi.org/10.1177/2333794x19865442.
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Participation of males in the prevention of mother-to-child transmission (PMTCT) programs remains a challenge despite the implementation of guidelines. The study aimed at exploring male involvement in the PMTCT program at a primary health facility in Lilongwe, Malawi. Focus group discussions and in-depth individual interviews were used to collect data from health care workers, men, and women who were attending PMTCT services. Snowball sampling was used to recruit participants who were purposively identified. Alcohol consumption, pressure from work places, stigma, role conflict, denial or nondisclosure of HIV status among women, and lack of awareness were among factors found to hinder male participation in PMTCT services. Therefore, to have an effective PMTCT program, male involvement is needed as this could positively influence the delivery of interventions including antiretroviral treatment among HIV-infected pregnant women. As such, health education awareness campaigns emphasizing the value of men in PMTCT services should be reinforced.
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Suryanti, Putu Emy, Komang Ayu Kartika Sari, Pande Putu Januraga, and Dinar Lubis. "Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study." Public Health and Preventive Medicine Archive 6, no. 1 (July 1, 2018): 73. http://dx.doi.org/10.15562/phpma.v6i1.13.
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AbstractBackground and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program.Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program.Results: The emerging themes related to the reasons of HIV-positive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program.Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.
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Suryanti, Putu Emy, Komang Ayu Kartika Sari, Pande Putu Januraga, and Dinar Lubis. "Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study." Public Health and Preventive Medicine Archive Journal 6, no. 1 (July 1, 2018): 1. http://dx.doi.org/10.15562/pphma.v6i1.13.
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AbstractBackground and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program.Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program.Results: The emerging themes related to the reasons of HIV-positive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program.Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.
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Yacobson, Irina, Morrisa Malkin, and Elena Lebetkin. "Increasing Access and Adherence to the PMTCT Cascade: Is There a Role for Economic Strengthening Interventions?" International Journal of Population Research 2016 (June 27, 2016): 1–8. http://dx.doi.org/10.1155/2016/4039012.
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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.
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Assefa, Sintayehu, and Dubale Dulla. "Willingness of antenatal care attendees towards voluntary HIV counseling and testing, Southern Ethiopia." International Journal of Pregnancy & Child Birth 6, no. 4 (August 19, 2020): 104–12. http://dx.doi.org/10.15406/ipcb.2020.06.00206.
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Background: Voluntary counseling and testing (VCT) is an entry point for the prevention of HIV transmission from mother to child and accessing VCT benefit from PMTCT services. Even though, some pregnant women clearly know the benefits /advantages of PMTCT services, they are not willing to test and access the services. Hence, this study was aimed to assess the willingness of pregnant women attending antenatal care towards VCT/PMTCT at Adare general hospital in southern Ethiopia. Method: An institution-based cross-sectional study was conducted at Hawassa Adare hospital, southern Ethiopia from February to April/2018. A total of 338 randomly selected pregnant women who were attending antenatal care clinic were included. Data was collected using structured and pretested questionnaire; entered and analyzed using SPSS version 20 computer software. Important descriptive and logistic models were used for data analysis assuming statistical significance at p < 0.05. Result: A total of 338 mothers were interviewed with a response rate of 100%. The willingness towards voluntary HIV counseling and testing among study participants was 82.2%. Participants who attended primary and High school and above were 3.9 (AOR= 3.87, 95% CI- 1.705, 8.782) and 9.5 times (AOR 9.53 at 95% CI- 3.155, 28.76); those who had good knowledge about VCT/PMTCT were 3.47 times (AOR=3.47, 95% CI-1.721, 7.003); women who followed two to three ANC visit, were 5.1 times more likely have willingness towards VCT/PMTCT (AOR 5.11 at 95% CI -1.095, 23.81) more likely willing to be tested than their counterparts respectively. Conclusion: Willingness towards voluntary HIV counseling was encouraging however it needs advancement. Since boosted knowledge and awareness promote willingness to VCT/PMTCT uptakes, initiation of community-based information dissemination, increased quality of ANC service, and empowering women to be educated could be effective in order to promote high VCT and PMTCT program uptakes
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Malava, Duece N., Peterson Muriithi, and Chrisostim Barasa. "Effect of Quality Improvement Approaches on Prevention of Mother to Child Transmission Services Coverage in Nairobi County." International Journal of Innovative Research in Medical Science 6, no. 05 (May 22, 2021): 316–28. http://dx.doi.org/10.23958/ijirms/vol06-i05/1130.
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Background: Improving the quality of healthcare is a growing international concern as it ensures that the healthcare system functions efficiently. Quality improvement in the HIV field focuses on achieving essential health outcomes, including patient retention, increasing viral load suppression, and improving overall health outcomes of people living with HIV. Quality Improvement (QI) approaches form part of the global strategies recommended by WHO to improve prevention of mother to child transmission (PMTCT) coverage and to achieve virtual elimination of mother to child transmission (MTCT). Nairobi County is implementing QI approaches using the Kenya Quality Model for Health (KQMH) framework. The implementation of QI began in January 2016, and since then, the facilities have formed work improvement teams (WITs) that work to improve the quality in the facilities. Study objective: This study sought to evaluate the effect of quality improvement approaches on PMTCT coverage in Nairobi County. Methodology: This quasi-experimental study applied a mixed-method research methodology. Purposive sampling determined the four study facilities. The participants were women attending the PMTCT clinic at the selected facilities, identified through a purposive sampling process. DHIS reports and facility registers provided the necessary quantitative data, while Focus Group Discussions (FGDs) and Key informant interviews (KIIs) provided qualitative data. Quantitative data showing service delivery uptake over time provided a trend on the performance of the key indicators under study. This data analysed using an interrupted time series approach as well as by using descriptive statistics showed trends over time. Qualitative data assessed clients’ experiences while accessing PMTCT services, providing key insights from the clients’ perspective. The researcher used content analysis to analyse this data. Results: The study found out that quality improvement is an integral part of PMTCT service delivery. Through the FGDs, the PMTCT services provided generally satisfy the clients’ needs, and that the clients have a significant role in quality improvement. The HCWs can implement QI approaches as long as they have the facility management's support and leadership. Conclusion: The study found out that quality improvement in PMTCT relies heavily on the systems being in place and on teamwork between the HCWs and clients as they access treatment services at the health facilities.
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Mnyani, Coceka Nandipha, and James McIntyre. "Challenges to delivering quality care in a prevention of mother-to-child transmission of HIV programme in Soweto, South Africa." Southern African Journal of HIV Medicine 14, no. 2 (June 4, 2013): 64–69. http://dx.doi.org/10.4102/sajhivmed.v14i2.80.
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Objectives: There has been little focus on quality of care provided in prevention of mother-to-child transmission of HIV (PMTCT) services in South Africa. We assessed quality of care in PMTCT services in Soweto, South Africa, focusing on knowledge and experiences of healthcare workers and HIV-infected pregnant women accessing the services. Methods: A cross-sectional survey was conducted between November and December 2009. A total of 201 HIV-infected pregnant women and 80 healthcare workers, from 10 antenatal clinics, were interviewed using standardised questionnaires. Results: The median gestational age at first antenatal visit was 20 weeks and 32 weeks at the time of the interview. The majority of the women, 71.5%, discovered that they were HIV-infected in the index pregnancy, and 87.9% disclosed their HIV status. Overall, 97.5% received counselling and 33.5% were members of a support group. Knowledge of antenatal and intrapartum PMTCT interventions was correct in 62.7% and 43.3% of the women, respectively. Support group membership and current use of antiretroviral prophylaxis did not impact on the quality of knowledge. Of the healthcare workers, 43.8% were professional nurses and 37.5% were lay counsellors. The majority, 80.0%, felt satisfied with their knowledge of PMTCT guidelines and 96.3% felt competent in managing HIV-infected pregnant women. Yet, there were important deficiencies in knowledge of the guidelines. Conclusion: In our study, knowledge of PMTCT interventions was low in both clients and healthcare workers. These findings point to a need to improve quality of care in PMTCT services, especially with increasingly complex PMTCT interventions recommended by international policies.
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Aishat, Usman, and Ayinde Olubunmi. "Prevention of Mother-to-Child Transmission of HIV/AIDS: Perception of Health Care Workers in Rural Areas of Oyo State." Scientifica 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/4257180.
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Introduction. Proper implementation of prevention of mother-to-child transmission (PMTCT) services requires adequate knowledge and appropriate attitudes and practices on the part of the health care providers especially in rural areas where access to health care delivery is very limited in Oyo State.Materials and Methods. This is a descriptive cross-sectional survey of 350 health care workers in a two-stage sampling technique. Data was obtained using interviewer-administered, pretested, semistructured questionnaires. The data was analyzed using Epi Info software version 7.Results. The knowledge of PMTCT of HIV was poor among the health care workers (69.1%). However, more than half (58.3%) had good attitudes towards PMTCT of HIV/AIDS. Predictors of good knowledge of PMTCT were religion [AOR = 1.6, 95% CI (1.1–2.6)], cadre of occupation [AOR = 10.2, 95% CI (2.9–35.1)], and length of service [AOR = 4.3, 95% CI (2.3–19.4)]. Predictors of good attitude towards PMTCT were length of service in the current hospital [AOR = 2.8, 95% CI (1.5–5.2)] and cadre of occupation [AOR = 3.9, 95% CI (1.28–11.9)].Conclusion. Despite poor knowledge of PMTCT of HIV/AIDS among the health care workers, the attitude towards PMTCT of HIV/AIDS was good. There is need for the involvement of the stakeholders in bridging the gap between knowledge of and attitude towards prevention of MTCT of HIV/AIDS among health care workers in the rural areas.
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Erliana, Nina, Antono Suryoputro, and Syamsulhuda Budi Mustofa. "Gambaran Pelaksanaan Prevention Mother to Child Transmission di RSUD Kelas B Dr. R. Sosodoro Djatikoesoemo Kabupaten Bojonegoro." Jurnal Promosi Kesehatan Indonesia 11, no. 2 (August 18, 2016): 1. http://dx.doi.org/10.14710/jpki.11.2.1-17.
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ABSTRACTEast Java Province in 2014 is the second of a number of provinces in Indonesia which has the prevalence of HIV/AIDS , in Bojonegoro (2015) being the order to -8 from 38 districts/cities in East Java as many as 718 cases of HIV/AIDS , in hospital Class B Dr . R. Sosodoro Djatikoesoemo district of Bojonegoro (2015) there were 178 people in inpatient and outpatient 1126 people with HIV/AIDS cases and 819 pregnant women only 6 were examined HIV in PMTCT services. This research will be conducted to analyze and describe the implementation of the PMTCT program In the Hospital Class B Dr. R. Sosodoro Djatikoesoemo Bojonegoro. This research is a qualitative descriptive exploratory with technique -indepth interviews against 5 key informants (5 Midwifes and 3 Specialist Doctors) and 5 informants triangulation (2 Midwiifes and 3 mothers who follow the PMTCT programs). The results are In the Hospital Class B Dr. R. Sosodoro Djatikoesoemo Bojonegoro haven’t the relevant Director’s SK PMTCT program, but the program is alreadyrun by Director’s SK of Organizational Structure of KPA in Hospital Class B Dr. R. Sosodoro Djatikoesoemo district of Bojonegoro which there PMTCT program implementation team as much as 5 people Midwives (which is already implementing PMTCT training Midwives 3) but never implement PMTCT program socialization to other health personnel at the hospital. PMTCT program is only implemented prongs 3 and 4 only, whereas prongs 1 and 2 has not been implemented because the patients who visit the PMTCT services are integrated in the KIA services only pregnant women, while the given information PMTCT and HIV testing is also only pregnant women who are at risk only , not on any pregnant women who visit. While it has never been no regular schedule related to evaluation and monitoring of the KPA and Bojonegoro District Health Office, but Hospital Class B Dr. R. Sosodoro Djatikoesoemo district of Bojonegoro regularly every month a report on the case of HIV/AIDS.Keywords: HIV/AIDS , pregnant women , PMTCT .
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MBONYE, A. K., K. S. HANSEN, F. WAMONO, and P. MAGNUSSEN. "BARRIERS TO PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES IN UGANDA." Journal of Biosocial Science 42, no. 2 (November 9, 2009): 271–83. http://dx.doi.org/10.1017/s002193200999040x.
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SummaryUnderstanding care-seeking practices and barriers to prevention of mother-to-child transmission (PMTCT) of HIV is necessary in designing effective programmes to address the high disease burden due to HIV/AIDS in Uganda. This study explored perceptions, care-seeking practices and barriers to PMTCT among young and HIV-positive women. A household survey (10,706 women aged 14–49 years), twelve focus group discussions and 66 key informant interviews were carried out between January and April 2009 in Wakiso district, central Uganda. Results show that access to PMTCT services (family planning, HIV counselling and testing and delivery at health units) was poor. Decision making was an important factor in accessing PMTCT services. Socioeconomic factors (wealth quintile, age, education level) and institutional practices also influenced access to PMTCT. Overall, having had an HIV test was highest when both men and women made decisions together or when women were empowered to make their own decisions. This was significant across wealth quintiles (p=0.0001), age groups (p=0.0001) and education levels (p=0.0001). The least level of HIV testing was when men made decisions for their spouses; and this was the case with family planning and deliveries at health units. Other barriers to PMTCT were fear of women and male spouses to have an HIV test and the perception that HIV testing is compulsory in antenatal clinics. In conclusion, to increase access to PMTCT among women, especially the young, poor and least educated, there is a need to empower them to make decisions on health seeking, and also to empower men to support their spouses to make good decisions. Other barriers like fear of having an HIV test should be addressed through appropriate counselling of clients.
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Adedimeji, Adebola, Nareen Abboud, Behailu Merdekios, and Miriam Shiferaw. "A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia." International Journal of Population Research 2012 (July 8, 2012): 1–7. http://dx.doi.org/10.1155/2012/532154.
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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.
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Okoko, Nicollate A., Kevin O. Owuor, Jayne L. Kulzer, George O. Owino, Irene A. Ogolla, Ronald W. Wandera, Elizabeth A. Bukusi, Craig R. Cohen, and Lisa L. Abuogi. "Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya." International Journal of STD & AIDS 28, no. 12 (February 9, 2017): 1215–23. http://dx.doi.org/10.1177/0956462417693735.
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Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case–control study of HIV-exposed infants between January and June 2012 was conducted at 20 clinics in Kenya. Cases were HIV-infected infants and controls were exposed, uninfected infants. Conditional logistic regression analysis was conducted to determine characteristics associated with HIV infection. Forty-five cases and 45 controls were compared. Characteristics associated with HIV-infection included poor PMTCT service uptake such as late infant enrollment (odds ratio [OR]: 7.1, 95% confidence interval [CI]: 2.6–16.7) and poor adherence to infant prophylaxis (OR: 8.3, 95%CI: 3.2–21.4). Maternal characteristics associated with MTCT included lack of awareness of HIV status (OR: 5.6, 95%CI: 2.2–14.5), failure to access antiretroviral prophylaxis (OR: 22.2, 95%CI: 5.8–84.6), and poor adherence (OR: 8.1, 95%CI: 3.7–17.8). Lack of clinic-based HIV education (OR: 7.7, 95%CI: 2.0–25.0) and counseling (OR: 8.3, 95%CI: 2.2–33.3) were reported by mothers of cases. Poor uptake of PMTCT services and a reported absence of HIV education and counseling at the clinic were associated with MTCT. More emphasis on high-quality, comprehensive PMTCT service provision are urgently needed to minimize HIV transmission to children.
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Merga, Hailu, Kifle Woldemichael, and Lamessa Dube. "Utilization of Prevention of Mother-to-Child Transmission of HIV Services and Associated Factors among Antenatal Care Attending Mothers in Sebeta Town, Central Ethiopia." Advances in Public Health 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/6250898.
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Background. HIV transmission from mother to child continues to be the major source of HIV infection among children under the age of fifteen. Targeting pregnant women attending antenatal clinics provides a unique opportunity for implementing prevention of mother-to-child transmission (PMTCT) programs against HIV infection of newborn babies. This study assessed utilization of PMTCT service of HIV and associated factors among ANC attending mothers.Methods. An institutional based cross-sectional study was conducted from February 20 to March 30, 2015, using exit interviews with 377 ANC attendees using consecutive sampling method. In-depth interviews with service provider were conducted to complement the quantitative data. Data were entered and analysed using EpiData and SPSS, respectively.Results. The prevalence of PMTCT service utilization was 86.9% in this study. Only 8.6% of respondents attended the facility for HCT. After controlling confounders using logistic regression, PMTCT service utilization was associated with age (25–34) of respondents (AOR (95% CI) = 0.46 (0.22, 0.97)), mother’s occupational status (being merchant AOR (95% CI) = 0.31 (0.12, 0.83), government employee AOR (95% CI) = 0.05 (0.01, 0.28), student AOR (95% CI) = 0.1 (0.01, 0.44), and daily laborer AOR (95% CI) = 0.13 (0.05, 0.33)), husband’s educational status (lack of formal education (AOR (95% CI) = 3.3 (1.1, 9.9))), having discussion with husband (AOR (95% CI) = 6.1 (2.6, 14.1)), partner tested (AOR (95% CI) = 8.2 (1.9, 34.46)), and being not satisfied with the service (AOR (95% CI) = 0.46 (0.2, 0.99)).Conclusions. This study revealed that utilization of HIV counseling and testing during antenatal care was high among pregnant women in Sebeta town. It highlights that focusing on improvement of quality and coverage of health services has significant effects on PMTCT service utilization. Effective use or uptake of ARV drug among HIV-positive pregnant women should be further investigated so that utilization will be enhanced.
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Ngangue, Patrice, Middle Fleurantin, Rheda Adekpedjou, Leonel Philibert, and Marie-Pierre Gagnon. "Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study." American Journal of Men's Health 15, no. 2 (March 2021): 155798832110060. http://dx.doi.org/10.1177/15579883211006003.
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This mixed-methods study aimed to determine the level of male involvement in the prevention of mother-to-child transmission (PMTCT) services in Haiti and identify barriers and associated factors. From May to June 2018, a questionnaire was used to measure the level of male involvement. Semistructured interviews with pregnant women were also conducted. Multivariate linear regression and qualitative content analyses were performed to explore factors associated and barriers to male partners’ involvement in PMTCT services. One hundred and two pregnant women living with HIV completed the questionnaire. About 47% of male partners had a high level of involvement. Specifically, 90% financially supported their spouse, and 82% knew her appointment date at the antenatal clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and 19% routinely used a condom during sexual intercourse. Factors associated with male involvement in PMTCT were being married and sharing HIV status with the male partner. Male partners with a positive HIV status were more likely to be involved in PMTCT. Qualitative findings revealed that barriers to male involvement included the conflict between opening hours of the ANC and the male partner’s schedule, waiting time at the ANC, and the perception of antenatal care as being women’s business. Overall male partners’ involvement in PMTCT services is moderate. Gender relations, sociocultural beliefs, and care organization are likely to hinder this involvement. Developing and implementing contextually and culturally accepted strategies for male partners of pregnant women could contribute to strengthening their involvement in the PMTCT program.
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Ongaki, Dominic, Mark Obonyo, Nancy Nyanga, and James Ransom. "Factors Affecting Uptake of PMTCT Services, Lodwar County Referral Hospital, Turkana County, Kenya, 2015 to 2016." Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821983883. http://dx.doi.org/10.1177/2325958219838830.
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Kenya is one of 22 countries globally that account for 90% of all HIV-positive pregnant women. This study aimed to determine factors affecting uptake of prevention of mother-to-child transmission (PMTCT) services among HIV-positive pregnant women at Lodwar County Referral Hospital in Turkana County, an arid area in northern Kenya. We conducted a retrospective review of HIV-positive pregnant women attending antenatal care (ANC) and accessing PMTCT services between January 2015 and December 2016. We used infant prophylaxis as a proxy measure of PMTCT uptake, and records across programs were linked using the mother’s unique medical identification number. A total of 230 participants were included in the study. Bivariate analyses showed maternal prophylaxis (odds ratio [OR] = 45.71; 95% confidence interval [CI]: 10.35-202.00), residing in urban center (OR = 2.64, 95% CI: 1.45-4.81), and having at least one ANC visit (OR = 2.78; 95% CI: 1.25-6.17) were significantly associated with uptake of PMTCT.
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Mulewa, Patience, Egrina Satumba, Christopher Mubisi, Joseph Kandiado, Tumaini Malenga, and Alinane Linda Nyondo-Mipando. "“I Was Not Told That I Still Have The Virus”: Perceptions of Utilization of Option B+ Services at a Health Center in Malawi." Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821987087. http://dx.doi.org/10.1177/2325958219870873.
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Utilization of the prevention of mother-to-child transmission of HIV (PMTCT) services remains a challenge as losses to follow-up are substantial. This study explored factors that influence adherence to maternal antiretroviral (ARV) medications among PMTCT mothers in Malawi. We conducted a descriptive qualitative study from September 2016 to May 2017 using purposive sampling among 16 PMTCT mothers and 4 key informant interviews with health-care workers. Data were audio-recorded and analyzed thematically. The factors that influence adherence to maternal ARV medications include the quality of PMTCT services and social support. Factors that impede adherence include suboptimal counseling women receive on ARV medications, cost of travel, and conflicting advice from religious institutions. Adherence to maternal ARV medications will require the use of existing social support systems in a woman’s life as a platform for delivery of the drugs while also maintaining continued and comprehensive counseling on the benefits of maternal ARV medications.
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Sitohang, Marya Yenita. "Utilization Factors of Prevention Mother to Child HIV Transmission (PMTCT) Program Among Pregnant Women." Journal of Indonesian Social Sciences and Humanities 7, no. 2 (December 28, 2017): 107–18. http://dx.doi.org/10.14203/jissh.v7i2.144.
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HIV transmission patterns had changed from high-risk groups to the group of housewives. Housewives will get pregnant and give birth. The possibility of a child contracting HIV from his mother can be prevented by utilizing the PMTCT program optimally. The objective of this research is to analyze the internal and external factors of PMTCT program utilization for pregnant women. This research used a critical review of previous studies (2009-2017). Social structures (education, occupation, and economic status) were not significantly related to the behavior of PMTCT program utilization. However, the availability of information and consultation with health officers (external factors) related to the knowledge and perception of pregnant women about HIV and the PMTCT program (internal factors). Good knowledge and perception would connect with the behavior of PMTCT program utilization. Negative stigma (external factor) from the family, community, and health officer made pregnant women reluctant to utilize the PMTCT program optimally. In conclusion, the need for increasing the quality of health services to become client-oriented as of widening the scope and optimization of the PMTCT program.
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Zegeye, Elias Asfaw, Josue Mbonigaba, and Sylvia Blanche Kaye. "Economic costs of patients attending the Prevention of Mother-to-Child Transmission of HIV/AIDS (PMTCT) services in Ethiopia : urban-rural setting." Acta Universitatis Danubius. Oeconomica 12, no. 4 (2016): 191–207. http://dx.doi.org/10.51415/10321/2974.
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Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT). This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence) and rural (low-HIV prevalence) settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory) and direct non-medical (food, transportation and accommodation). The mean direct medical expense per patient per year was Ethiopian birr (ETB) 746 (US$ 38) in the urban settings, as compared to ETB 368 (US$ 19) in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327) and ETB 2,154 (US$ 110) per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132) and ETB 2,919 (US$ 148.39) in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.
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Wiraharja, Regina Satya, Laksono Trisnantoro, Yodi Mahendradhata, and Ignatius Praptoharjo. "Challenges of PMTCT and MCHS Integration in Indonesia, Analysis by Integration Analysis Framework and CFIR." Jurnal Kesehatan Masyarakat 14, no. 3 (May 21, 2019): 359–68. http://dx.doi.org/10.15294/kemas.v14i3.14570.
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Integration was strategy of PMTCT (Prevention of Mother to Child HIV Transmission) and MCHS (Mother and Child Health Services) since 2006. This systematic review explored integration level between PMTCT and MCHS. Literature searched from June 2015 to January 2016 through Google, Google Scholar, University Library Website, Portal Garuda, ProQuest, PubMed and 90 institutions in Jakarta. Keywords were PMTCT, HIV Mother, PPIA HIV Evaluation and HIV PMTCT Evaluation. We yielded 157 literatures from 1995-2015. Research should be done at Public Primary Health Care (PHC), discussed PMTCT implementation, and captured perspectives of staffs or decision makers. Thematic analysis was done using Atun’s Integration Analysis Framework and CFIR. We included 7 studies. No study explored overall dimensions of integration, especially planning function. Challenges were resources, execution, needs of patients, networks and communications, policies, leadership, and access to information. Only 4 studies showed PMTCT results. Coverage of first visit counseling was 9-100% and percentage of pregnant women tested was 3.9 -60%. PMTCT integration was partial. Integration was not a sole solution to results. Planning should be done together with regional and local level, involving stakeholders to disseminate PMTCT information, increasing ownership and leadership. We proposed Atun’s Framework and CFIR for further research.
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Mandala, Justin, Prisca Kasonde, Titilope Badru, Rebecca Dirks, and Kwasi Torpey. "HIV Retesting of HIV-Negative Pregnant Women in the Context of Prevention of Mother-to-Child Transmission of HIV in Primary Health Centers in Rural Zambia: What Did We Learn?" Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821882353. http://dx.doi.org/10.1177/2325958218823530.
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Background: This observational study describes implementation of HIV retesting of HIV-negative women in prevention of mother-to-child transmission (PMTCT) services in Zambia. Methods: Uptake of retesting and PMTCT services were compared across age, parity, and weeks of gestation at the time of the first HIV test, antiretrovirals regime, and HIV early diagnosis results from infants born to HIV-positive mothers. Results: A total of 19 090 pregnant women were tested for HIV at their first antenatal visit, 16 838 tested HIV-negative and were offered retesting 3 months later: 11 339 (67.3%) were retested; of those, 55 (0.5%) were HIV positive. Uptake of the PMTCT package by women HIV positive at retest was not different but HIV-exposed infants born to women who retested HIV positive were infected at a higher rate (11.1%) compared to those born to women who tested HIV positive at their initial test (3.2%). Conclusion: We suggest rigorously (1) measuring the proportion of MTCT attributable to women who seroconvert during pregnancy and possibly adjust PMTCT approaches and (2) addressing the substantial loss to follow-up of HIV-negative pregnant women before HIV retesting.
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Ramoshaba, Refilwe, and Sello Levy Sithole. "Knowledge and Awareness of MTCT and PMTCT Post-Natal Follow-up Services Among HIV Infected Mothers in the Mankweng Region, South Africa." Open AIDS Journal 11, no. 1 (June 30, 2017): 36–44. http://dx.doi.org/10.2174/1874613601711010036.
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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.
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O Olakunde, Babayemi, Sabastine Wakdok, Yewande Olaifa, Francis Agbo, Uduak Essen, Mathews Ojo, Maria Oke, and Sarah Ibi. "Improving the coverage of prevention of mother-to-child transmission of HIV services in Nigeria: should traditional birth attendants be engaged?" International Journal of STD & AIDS 29, no. 7 (December 4, 2017): 687–90. http://dx.doi.org/10.1177/0956462417745200.
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Traditional birth attendants (TBAs) play an important role in the provision of care to pregnant women in rural parts of Nigeria, but they are barely engaged by the formal healthcare system in expanding the low coverage of prevention of mother-to-child transmission of HIV (PMTCT) services. Using a systematic approach, we engaged TBAs in Abia and Taraba States to scale-up PMTCT services under the National Agency for Control of AIDS Comprehensive AIDS Program with States. We conducted mapping of the TBAs, built their capacities, obtained their buy-in on mobilization of their clients and other pregnant women for HIV testing service outreaches, and established referral and linkage systems. A total of 720 TBAs were mapped (Abia 407; Taraba 313). Three hundred and ninety-nine TBAs who participated in the capacity-building meeting were linked to 115 primary healthcare centers (PHCs) in Abia State, while 245 TBAs were linked to 27 PHCs in Taraba State. From July 2016 to March 2017, the outreaches contributed 20% to the overall total number of pregnant women counseled, tested and received results, and 12% to the total number of HIV-infected women identified. There was a considerable yield of HIV-infected pregnant women among those tested in the TBA outreaches in comparison with the supported antenatal facilities (2% versus 3%, respectively). Engaging TBAs has the potential to improve the coverage of PMTCT services in Nigeria.
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Kinyua, Kevin, Prisca Muange, Benard Makenzi, Charles Kimani, and Aurora O. Amoah. "Applying Quality Improvement Strategies to Health Services for HIV-Affected Mother–Baby Pairs in Rural Kenya." Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821985797. http://dx.doi.org/10.1177/2325958219857977.
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The Partnership for HIV-Free Survival (PHFS) was piloted in rural Kenya using a quality improvement approach to integrate nutrition with prevention of mother-to-child transmission (PMTCT) of HIV services. Data were collected in a preintervention baseline (January 2013 to August 2013) and 3 periods during implementation (September 2013 to June 2016). Integration of nutrition assessment, counseling, and support (NACS) in PMTCT and retention of mother–baby pairs (MBPs) in care showed significant increase over time: The MBPs receiving NACS increased from a baseline median of 15% to 88% ( P ≤ .05), and the proportion of MBPs retained in active care increased from a baseline median of 19% to a median of 66% ( P ≤ .01). Declines observed in the number of HIV-exposed infants who tested positive for HIV at 18 months were not statistically significant. The PHFS was successful in integrating NACS into PMTCT services and increasing retention of MBPs in care in Kenya.
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Ehiri, John E., Halimatou S. Alaofè, Victoria Yesufu, Mobolanle Balogun, Juliet Iwelunmor, Nidal A.-Z. Kram, Breanne E. Lott, and Olayinka Abosede. "AIDS-related stigmatisation in the healthcare setting: a study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria." BMJ Open 9, no. 5 (May 17, 2019): e026322. http://dx.doi.org/10.1136/bmjopen-2018-026322.
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ObjectiveTo assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria.DesignCross-sectional survey.SettingThirty-eight primary healthcare centres in Lagos, Nigeria.ParticipantsOne hundred and sixty-one PMTCT service providers.Outcome measuresPMTCT service providers’ discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies).ResultsReported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion.ConclusionsThis study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.
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Theuring, Stefanie, Paulina Mbezi, Hebel Luvanda, Brigitte Jordan-Harder, Andrea Kunz, and Gundel Harms. "Male Involvement in PMTCT Services in Mbeya Region, Tanzania." AIDS and Behavior 13, S1 (March 24, 2009): 92–102. http://dx.doi.org/10.1007/s10461-009-9543-0.
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BANKOLE, AKINRINOLA, ANN E. BIDDLECOM, KUMBUTSO DZEKEDZEKE, JOSHUA O. AKINYEMI, OLUTOSIN AWOLUDE, and ISAAC F. ADEWOLE. "DOES KNOWLEDGE ABOUT ANTIRETROVIRAL THERAPY AND MOTHER-TO-CHILD TRANSMISSION AFFECT THE RELATIONSHIPS BETWEEN HIV STATUS AND FERTILITY PREFERENCES AND CONTRACEPTIVE USE? NEW EVIDENCE FROM NIGERIA AND ZAMBIA." Journal of Biosocial Science 46, no. 5 (December 16, 2013): 580–99. http://dx.doi.org/10.1017/s0021932013000655.
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SummaryThe increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009–2010 community-based surveys in Nigeria and Zambia, this study explores whether women's knowledge about ART and PMTCT influences the relationship between HIV status and fertility preferences and contraceptive behaviour. The findings show that women living with HIV are more likely to want more children in Nigeria and to want to limit childbearing in Zambia compared with HIV-negative women. While there is no significant difference in contraceptive use by women's HIV status in the two countries, women who did not know their HIV status are less likely to use contraceptives relative to women who are HIV-negative. Knowledge about ART reduces the childbearing desires of HIV-positive women in Nigeria and knowledge about PMTCT increases desire for more children among HIV-positive women in Zambia, as well as contraceptive use among women who do not know their HIV status. The findings indicate that knowledge about HIV prevention and treatment services changes how living with HIV affects childbearing desires and, at least in Zambia, pregnancy prevention, and highlight the importance of access to accurate knowledge about ART and PMTCT services to assist women and men to make informed childbearing decisions. Knowledge about ART and PMTCT should be promoted not only through HIV treatment and maternal and newborn care facilities but also through family planning centres and the mass media.
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Muheriwa, Sadandaula R., Angela Chimwaza, Alfred Maluwa, and Martha Kamanga. "Young Women’s Knowledge and Utilization of Prevention of Mother-to-Child Transmission (PMTCT) of HIV Services: Is There Any Relationship?" International Journal of Childbirth 2, no. 3 (2012): 163–72. http://dx.doi.org/10.1891/0886-6708.2.3.163.
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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.
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Siregar, Kemal Nazaruddin, Laily Hanifah, Rikawarastuti, and Lely Wahyuniar. "Prevention of HIV Transmission from Mother to Child: Challenges to the Successful Program Implementation and Practice in Indonesia." Journal of the International Association of Providers of AIDS Care (JIAPAC) 20 (January 1, 2021): 232595822110407. http://dx.doi.org/10.1177/23259582211040701.
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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.
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Adnyani, Ni Wayan Sukma, Ni Made Rai Widiastuti, and Ketut Novia Arini. "GAMBARAN PELAKSANAAN PPIA PADA KUNJUNGAN AWAL ANTENATAL CARE OLEH BIDAN PRAKTEK MANDIRI (BPM) DI KOTA DENPASAR TAHUN 2018." Jurnal Genta Kebidanan 8, no. 2 (December 5, 2018): 65. http://dx.doi.org/10.36049/jgk.v8i2.154.
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<p><strong>Abstract: <em>Characteristics and Implementation of PMTCT in The Initial Visit Of Antenatal Care By Independent Practice Midwife (BPM) In Denpasar City</em></strong><strong><em>.</em></strong> Based on data from the Bali Provincial Health Office (2014), the number of pregnant women who were willing to take the PMTCT test was 5,029 (42.91%) of the national target achievement of 78% of pregnant women who were tested for HIV. Independent Practice Midwives (BPM) as maternal and child health services that offer and provide PPIA services during ANC visits. This study seeks to determine description of the implementation of PMTCT by midwife practice independent. This research is a descriptive study using a cross-sectional approach. The sample selection used a total sampling technique in which 73 BPM met the inclusion criteria. The results of this study showed 60.3% of midwives with education <span style="text-decoration: underline;"><</span> D3 Midwifery, 60.3% of midwives were in the age range > 40 - 60 years, and most of them were 74% midwives carried out PMTCT services in accordance with the provisions that were offered the initial visit and a small portion of 26% of midwives did not carry out PMTCT services according to the provisions, but referred patients to PMTCT on the next visit when the nausea and vomiting had disappeared. Thus, supervision from policy makers from the Ministry of Health and Community Health Centers (Puskesmas) is very important in conducting a review of the implementation of PPIA regularly to increase the scope of PPIA in BPM.</p><p><strong><em>Key words : </em></strong><em>Pregnancy,PMTCT, </em><em>Independent Practice Midwives</em><em></em></p><p><strong>Abstrak : Karakteristik dan Gambaran Pelaksanaan PPIA pada Kunjungan Awal Antenatal Care oleh Bidan Praktek Mandiri (BPM) Di Kota Denpasar</strong><strong>. </strong>Berdasarkan data Dinas Kesehatan Provinsi Bali (2014), jumlah wanita hamil yang bersedia melakukan tes PMTCT adalah 5.029 (42,91%) dari pencapaian target nasional yaitu 78% dari wanita hamil yang dites HIV. Bidan Praktek Mandiri (BPM) sebagai tempat pelayanan kesehatan Ibu dan Anak yang menawarkan dan memberikan pelayanan PPIA dalam kunjungan ANC. Penelitian ini berusaha untuk mengetahui gambaran pelaksanaan PPIA oleh BPM Penelitian ini merupakan penelitian deskriptif dengan menggunakan pendekatan <em>cross-sectional</em>. Pemilihan sampel menggunakan teknik total sampling di mana 73 BPM memenuhi kriteria inklusi. Hasil penelitian ini menunjukkan sebanyak 60,3% dengan pendididkan <span style="text-decoration: underline;"><</span> D3 Kebidanan, 60,3% dalam rentang umur > 40 – 60 tahun, dan sebagian besar yaitu 74% bidan melaksanakan pelayanan PPIA sesuai dengan ketentuan yaitu ditawarkan pemeriksaan pada kunjungan awal dan sebagian kecil yaitu 26% bidan belum melaksanakan pelayanan PPIA sesuai ketentuan, melainkan merujuk pasien untuk PPIA pada di kunjungan berikutnya saat mual muntah sudah hilang. Dengan demikian, pengawasan dari pembuat kebijakan dari Departemen Kesehatan dan Pusat Kesehatan Masyarakat (Puskesmas) sangat penting dalam melakukan tinjauan mengenai pelaksanaan PPIA secara teratur untuk meningkatkan ruang lingkup PPIA di BPM.<strong></strong></p><p><strong>Kata kunci</strong>: Kehamilan, PPIA, Bidan Praktek Mandiri,</p><p><strong> </strong></p>
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O. Isichei, Christian. "The Role of Trained Birth Attendants in Delivering PMTCT Services." American Journal of Health Research 3, no. 4 (2015): 232. http://dx.doi.org/10.11648/j.ajhr.20150304.15.
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Puchalski Ritchie, Lisa M., Monique van Lettow, Ba Pham, Sharon E. Straus, Mina C. Hosseinipour, Nora E. Rosenberg, Sam Phiri, Megan Landes, and Fabian Cataldo. "What interventions are effective in improving uptake and retention of HIV-positive pregnant and breastfeeding women and their infants in prevention of mother to child transmission care programmes in low-income and middle-income countries? A systematic review and meta-analysis." BMJ Open 9, no. 7 (July 2019): e024907. http://dx.doi.org/10.1136/bmjopen-2018-024907.
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ObjectiveThis review was conducted to identify interventions effective in improving uptake and retention of HIV-positive mothers and their infants in prevention of mother to child transmission (PMTCT) services in low-income and middle-income countries (LMICs) in order to inform programme planning.MethodsWe conducted a systematic review of studies comparing usual care with any intervention to improve uptake and retention of HIV-positive pregnant or breastfeeding women and their children from birth to 2 years of age in PMTCT services in LMICs. Twenty-two electronic databases were searched from inception to 15 January 2018, for randomised, quasi-randomised and non-randomised controlled trials, and interrupted time series studies; reference lists of included articles were searched for relevant articles. Risk of bias was assessed using the Cochrane Effective Practice and Organisation of Care group criteria. Random-effects meta-analysis was conducted for studies reporting similar interventions and outcomes.ResultsWe identified 29 837 articles, of which 18 studies were included in our review. Because of heterogeneity in interventions and outcome measures, only one meta-analysis of two studies and one outcome was conducted; we found a statistically significant increase in antiretroviral therapy (ART) use during pregnancy for integration of HIV and antenatal care relative to standard non-integrated care (pooled AOR=2.69; 95% CI 1.25 to 5.78, p=0.0113). The remaining studies assessing other patient, provider or health system interventions were synthesised narratively, with small effects seen across intervention categories for both maternal and infant PMTCT outcomes based predominately on evidence with moderate to high risk of bias.ConclusionsEvidence on the effectiveness of interventions to improve uptake and retention of mothers and infants in PMTCT care is lacking. Our findings suggest that integration of HIV and antenatal care may improve ART use during pregnancy. Future studies to replicate promising approaches are needed. Improved reporting of key methodological criteria will facilitate interpretation of findings and improve the utility of evidence to PMTCT programme planners.PROSPERO registration numberCRD42015020829.
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Nahar, Shamsun, SM Khaliduzzaman, Parul Akter, and Zannatul Ferdous Jesmin. "Prevention of Mother to Child Transmission in HIV Antenatal and Postnatal Screening in Khulna Medical College." Medicine Today 33, no. 1 (February 25, 2021): 7–11. http://dx.doi.org/10.3329/medtoday.v33i01.52150.
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Introduction: Prevention of Mother to Child Transmission (PMTCT) program, offers a range of services for women of reproductive age living with or at risk of HIV to maintain health and stop their infants from acquiring HIV. PMTCT services should be commenced before conception and throughout pregnancy, labor and breast feeding. Around 1.4 million HIV infections among children were prevented between 2010 and 2018 by PMTCT program. UNFPO started antenatal screening program in collaboration with AIDS/STD program in Bangladesh from 2013, in 12 centers (BSMMU, 4 Medical College Hospitals, 3 Sadar Hospitals, 3 Health Complexes and Memon Maternity Hospital, Chittagong).
Materials and Methods: Observational study of Antenatal and postnatal cases in HIV screening in KMCH during the period of Nov’2017 to March’2020.
Results: From November 2017 to March 2020, total 18,911 patients screened, 11 patients were found HIV positive. 2 patients dropped out. Among 9 patients, 6 patients were detected in antenatal and 3 in postnatal period. 6 patients had vaginal delivery, 2 elective caesarean section and 1 patient had abortion. Screening was done by Alere Determine HIV- ½ Ag/Ab Combotest and diagnosis was confirmed by Uni-Gold HIV Rapid Test and First Response HIV 1-2-0 Card test.
Conclusion: Following confirmation, ARV started with proper counseling. All babies were breast fed. The neonates were screened by PCR at their age of 45 days and found negative. WHO guideline was strictly maintained during labor conduction and cesarean sections. PMTCT program should be expanded in all institutions to detect cases, reduce transmission, contraception counselling to reduce confirmed cases.
Medicine Today 2021 Vol.33(1): 7-11
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Berlacher, Michelle, Timothy Mercer, Edith O. Apondi, Winfred Mwangi, Edwin Were, and Megan S. McHenry. "Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya." International Journal of Maternal and Child Health and AIDS (IJMA) 10, no. 1 (December 30, 2020): 19–28. http://dx.doi.org/10.21106/ijma.429.
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Background: Health systems integration is becoming increasingly important as the global health community transitions from acute, disease-specific health programming to models of care built for chronic diseases, primarily designed to strengthen public-sector health systems. In many countries across sub-Saharan Africa, including Kenya, prevention of mother-to-child transmission of HIV (pMTCT) services are being integrated into the general maternal child health (MCH) clinics. The objective of this study was to evaluate the benefits and challenges for integration of care within a developing health system, through the lens of an evaluative framework. Methods: A framework adapted from the World Health Organization’s six critical health systems functions was used to evaluate the integration of pMTCT services with general MCH clinics in western Kenya. Perspectives were collected from key stakeholders, including pMTCT and MCH program leadership and local health providers. The benefits and challenges of integration across each of the health system functions were evaluated to better understand this approach. Results: Key informants in leadership positions and MCH staff shared similar perspectives regarding benefits and challenges of integration. Benefits of integration included convenience for families through streamlining of services and reduced HIV stigma. Concerns and challenges included confidentiality issues related to HIV status, particularly in the context of high-volume, crowded clinical spaces. Conclusion and Global Health Implications: The results from this study highlight areas that need to be addressed to maximize the effectiveness and clinical flow of the pMTCT-MCH integration model. The lessons learned from this integration may be applied to other settings in sub-Saharan Africa attempting to integrate HIV care into the broader public-sector health system. Key words: • HIV prevention • Maternal-child health • Prevention of maternal-to-child transmission • Health services • Integration • Kenya • Sub-Saharan Africa Copyright © 2020 Berlacher et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.
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Kiragu, Karusa, Lynn Collins, Deborah Von Zinkernagel, and Angela Mushavi. "Integrating PMTCT Into Maternal, Newborn, and Child Health and Related Services." JAIDS Journal of Acquired Immune Deficiency Syndromes 75 (May 2017): S36—S42. http://dx.doi.org/10.1097/qai.0000000000001323.
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Moth, Iscah Akoth, A. B. C. O. Ayayo, and Dan Kaseje. "Assessment of utilisation of PMTCT services at Nyanza Provincial Hospital, Kenya." SAHARA-J: Journal of Social Aspects of HIV/AIDS 2, no. 2 (July 2005): 244–50. http://dx.doi.org/10.1080/17290376.2005.9724847.
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Astawesegn, Feleke Hailemichael, Virginia Stulz, Kingsley E. Agho, Haider Mannan, Elizabeth Conroy, and Felix Akpojene Ogbo. "Prenatal HIV Test Uptake and Its Associated Factors for Prevention of Mother to Child Transmission of HIV in East Africa." International Journal of Environmental Research and Public Health 18, no. 10 (May 16, 2021): 5289. http://dx.doi.org/10.3390/ijerph18105289.
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Identifying the socioeconomic and structural issues that act as enablers and/or barriers to HIV testing services is critical in combatting HIV/AIDS amongst mothers and children in Africa. In this study, we used a weighted sample of 46,645 women aged 15–49 who gave birth in the two years preceding the survey from the recent DHS dataset of ten East African countries. Multivariable logistic regression was used to investigate the factors associated with prenatal HIV test uptake in East Africa. The overall prenatal HIV test uptake for the prevention of mother-to-child transmission (PMTCT) of HIV was 80.8% (95% CI: 74.5–78.9%) in East Africa, with highest in Rwanda (97.9%, 95% CI: 97.2–98.3%) and lowest in Comoros (17.0%, 95% CI: 13.9–20.7%). Common factors associated with prenatal HIV test service uptake were higher maternal education level (AOR = 1.29; 95% CI: 1.10–1.50 for primary education and AOR = 1.96; 95% CI: 1.53–2.51 for secondary or higher education), higher partner education level (AOR = 1.24; 95% CI: 1.06–1.45 for primary education and AOR = 1.56; 95% CI: 1.26–1.94 for secondary or higher school), women from higher household wealth index (AOR = 1.29; 95% CI: 1.11–1.50 for middle wealth index; AOR = 1.57; 95% CL: 1.17–2.11 for rich wealth index), improved maternal exposure to the media, and increased awareness about MTCT of HIV. However, residents living in rural communities (AOR = 0.66; 95% CI: 0.51–0.85) and travelling long distances to the health facility (AOR = 0.8; 95% CI: 0.69–0.91) were associated with non-use of prenatal HIV test service in East African countries. In each East African country, factors associated with prenatal HIV test uptake for PMTCT varied. In conclusion, the pooled prenatal HIV test uptake for PMTCT of HIV was low in East Africa compared to the global target. Scaling up interventions to improve enablers whilst addressing barriers to the use of prenatal HIV test services are essential to end the HIV/AIDS epidemic in East African countries.
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Mandell, Lissa N., Violeta J. Rodriguez, Karl Peltzer, Stephen M. Weiss, and Deborah L. Jones. "Fertility intentions of women living with HIV and their male partners during the perinatal period in rural South Africa." International Journal of STD & AIDS 32, no. 8 (March 26, 2021): 740–50. http://dx.doi.org/10.1177/0956462420987447.
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Understanding the fertility intentions of people living with HIV can guide safer conception planning and prevention of mother-to-child transmission (PMTCT). Most research has addressed fertility intentions among women, rather than couples, at a single time point. This clinical trial of a PMTCT intervention in rural Mpumalanga province, South Africa, examined longitudinal fertility intentions among perinatal women living with HIV and their male partners. Study assessments and intervention and control sessions were conducted prenatally and postpartum. Longitudinal predictors of participants’ ( n = 360 men, n = 917 women) fertility intentions were similar between sexes. Younger age and male involvement in perinatal care were associated with reporting fertility intentions at both baseline and 12 months postpartum. Having an HIV-positive infant and discussing pregnancy plans with a healthcare provider by 12 months postpartum were associated with incident fertility intentions after reporting no plans for further children at baseline. Results highlight the important role of healthcare providers to educate men and women on issues surrounding conception, as well as the potential for incorporating PMTCT and safer conception education into HIV clinical services.
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Lorenzetti, Lara, Mandy Swann, Andres Martinez, Amy O’Regan, Jamilah Taylor, and Alexis Hoyt. "Using financial diaries to understand the economic lives of HIV-positive pregnant women and new mothers in PMTCT in Zomba, Malawi." PLOS ONE 16, no. 7 (July 30, 2021): e0252083. http://dx.doi.org/10.1371/journal.pone.0252083.
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Background Economic strengthening (ES) interventions can address economic barriers to retention and adherence (R&A) to antiretroviral therapy in prevention of mother-to-child transmission (PMTCT) services. To inform tailoring of ES activities for PMTCT, we used financial diaries to understand the economic lives of women in PMTCT and examine associations between participants’ finances and their R&A. Methods We collected financial data from a stratified sample (n = 241) of HIV-positive pregnant women and new mothers enrolled in PMTCT from three clinics in Zomba, Malawi. For 30 weeks, participants met with staff to record cash and in-kind inflows and outflows. We used clinical records to calculate a measure of R&A for each participant. We summarized diary data using R and used cox proportional hazard models to examine the relationship between R&A and participant characteristics and behavior. Results There were 68,097 cash transactions over 30 weeks, with 10% characterized as inflows. The median value of cash inflows was US$3.54 compared with US$0.42 for cash outflows. Fewer than 7% of total transactions were considered related to PMTCT, with the majority classified as food or drink. Participants in the rural site had the lowest hazard of non-adherence. Decreased hazard of non-adherence was also linked to having dependents and years on ART. There were significant differences in cash inflows and outflows between those who were always adherent and those who were not. Conclusions Financial inflows were large and erratic, whereas outflows were small but consistent. PMTCT expenses comprised a small proportion of overall expenses and focused on proper nutrition. The influence of inflows and outflows on adherence was significant but small; however, always adherent participants demonstrated smoother inflows and outflows, indicating an association between greater adherence and economic stability. Participants would benefit from interventions that bolster and stabilize their economic lives, including income generating activities in the agricultural industry and inclusion in village banks.
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Dillabaugh, Lisa L., Jayne Lewis Kulzer, Kevin Owuor, Valerie Ndege, Arbogast Oyanga, Evelyne Ngugi, Starley B. Shade, Elizabeth Bukusi, and Craig R. Cohen. "Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya." AIDS Research and Treatment 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/602120.
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Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010–Jan 2011), during the RRI, and post-RRI (Jul–Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2–1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4–1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9–1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0–1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants.
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Yuliyatni, Putu Cintya Denny, Wayan Pujana, and Citra Indriani. "Evaluation of HIV screening at antenatal care settings in Denpasar City." Public Health and Preventive Medicine Archive 5, no. 1 (July 1, 2017): 33. http://dx.doi.org/10.15562/phpma.v5i1.39.
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Background and purpose: National strategy to increase the coverage of prevention of mother to child transmission (PMTCT) program in Indonesia is integrating the service into public health centres (puskesmas). In Bali, the integration has been started since 2014. After one year of program implementation, an evaluation was conducted in order to provide input and feedback for program improvement.Methods: Secondary data analysis and indepth interview with 13 key informants in Denpasar City were conducted to assess input, process and output of the integration implementation. Results: Of the 11,719 pregnant women targeted within the program, 43% were offered to undergo HIV testing and 98% of these agreed to have HIV test with 17 were found HIV positive. Interviews with key informants found that there were adequate resources both in terms of manpower, funds and equipment. Obstacles found in the implementation include different site of ANC and HIV testing facility. The other barrier was high number of pregnant mother who conducted ANC at private obstetrician which not yet included in the program.Conclusions: Integration of PMTCT into ANC services at public health centre (PHC) is an effective way to improve the uptake of HIV screening among pregnant women. However, there is a need of effective of referral systems from private midwives and PHC satellite services. The expansion of networks into private midwives and obstetrician will be instrumental in improving performance outcomes.
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Pellowski, Jennifer, Catherine Wedderburn, Jacob A. M. Stadler, Whitney Barnett, Dan Stein, Landon Myer, and Heather J. Zar. "Implementation of prevention of mother-to-child transmission (PMTCT) in South Africa: outcomes from a population-based birth cohort study in Paarl, Western Cape." BMJ Open 9, no. 12 (December 2019): e033259. http://dx.doi.org/10.1136/bmjopen-2019-033259.
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ObjectivesThe coverage of prevention of mother-to-child transmission (PMTCT) services in South Africa is variable. Identifying gaps in the implementation of these services is necessary to isolate steps needed to further reduce paediatric infections and eliminate transmission.SettingTwo primary care clinics in Paarl, South Africa.Participants1225 pregnant women; inclusion criteria were 18 years or older, clinic attendance and remaining in area for at least 1 year.MethodsData were collected through the Drakenstein Child Health Study, a population-based birth cohort in a periurban area of the Western Cape, South Africa. A combination of clinic records, hospital records, national database searches and maternal self-report were collected during the study.ResultsOf the 1225 mothers enrolled in the cohort between 2012 and 2015, 260 (21%) were confirmed HIV infected antenatally and 1 mother tested positive in the postnatal period. Of those with documentation (n=250/260, 96%), the majority (99%) received antiretroviral prophylaxis or therapy (ART) before labour; however, there was a high rate of defaulting from ART noted during pregnancy (20%). All HIV-exposed infants with data received antiretroviral prophylaxis, 35% were exclusively breast fed until 6 weeks and 16% for 6 months. There were two cases of infant HIV infection (0.8%) who were initiated on ART but had complicated histories.ConclusionDespite the low transmission rate in this cohort, reaching elimination will require further work, and this study illustrates several areas to improve implementation of PMTCT services and reduce paediatric infections including retesting at-risk HIV-negative mothers through the duration of breast feeding, infant HIV testing at any admission in addition to routine testing and improved counselling to prevent defaulting from treatment. Better data surveillance systems are essential for determining the implementation of PMTCT guidelines.
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Madiba, Sphiwe, and Mamorapeli Putsoane. "Testing Positive and Disclosing in Pregnancy: A Phenomenological Study of the Experiences of Adolescents and Young Women in Maseru, Lesotho." AIDS Research and Treatment 2020 (February 12, 2020): 1–8. http://dx.doi.org/10.1155/2020/6126210.
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The routine antenatal screening through the prevention of mother to child transmission of HIV (PMTCT) services results in pregnancy being often the point at which an HIV diagnosis is made. Disclosure to partners presents particular complexities during pregnancy. However, research on the pattern and experiences of disclosure in pregnancy is limited in Lesotho, despite the high prevalence of HIV among pregnant women. The aim of this study was to explore and describe the disclosure experiences of adolescent girls and young women (AGYW) after receiving a positive HIV test result during pregnancy. Methods. Descriptive phenomenology using semistructured in-depth interview was used to collect data from AGYM sampled purposively from PMTCT sites located in urban areas of Maseru, Lesotho. Data analysis was inductive and followed the thematic approach. Findings. There were 15 AGYW involved in this study with the mean age of 20 years. Fourteen reported being pregnant with their first child and perceived HIV testing in antenatal care as compulsory. Ten AGYM disclosed their HIV status in the immediate posttesting period to protect their partners from HIV infection. The narratives revealed that the AGYM hoped that after disclosing, the partner would be tested for HIV. Furthermore, the AGYM disclosed because they wanted freedom to take their medication. Their experience of disclosure was relief, as they did not have to hide their HIV status. The AGYM reported being supported to adhere to medication and clinic attendance by their partners who also provided emotional support to them to deal with being HIV positive and pregnant. Conclusion. The AGYM recounted an overall positive experience of disclosure to their partners who agreed to test for HIV and adopted safe sex practices. This has positive implications for the PMTCT programme and the involvement of men in reproductive health. Therefore, there is need to integrate disclosure and partner testing interventions in the cascade of services in PMTCT programmes.
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Osibo, Bamidele, Frank Oronsaye, Oluwafemi D. Alo, Abimbola Phillips, Renaud Becquet, Nathan Shaffer, Francis Ogirima, et al. "Using Small Tests of Change to Improve PMTCT Services in Northern Nigeria." JAIDS Journal of Acquired Immune Deficiency Syndromes 75 (June 2017): S165—S172. http://dx.doi.org/10.1097/qai.0000000000001369.
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Skinner, Donald, Sakhumzi Mfecane, Tebogo Gumede, Nomvo Henda, and Adlai Davids. "Barriers to accessing PMTCT services in a rural area of South Africa." African Journal of AIDS Research 4, no. 2 (November 2005): 115–23. http://dx.doi.org/10.2989/16085900509490350.
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