Reasons for Default from Prevention of Mother to Child Transmissions (PMTCT) of HIV Program in Addis Ababa
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Date
2007-07
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Addis Ababa University
Abstract
Back Ground: As of February 2004 Prevention of Mother to child
transmission of HIV program was started as “hareg” project at five health
facilities in Addis Ababa which later expanded to 33 sites. Since its
starts, yearly regional health bureau report showed that the region didn`t
achieved the national Prevention of Mother to child transmission of HIV
program target in relation to counseling and test acceptance. More ever
less than half of HIV positive mothers and their infant have taken full
course of Nevirapin while the other half default from Prevention of
Mother to child transmission of HIV program and they didn`t take
Nevirapin.
Objective: the main objective of the study is to identify reasons of HIV
positive women for defaulting from PMTCT program and not taking ARV
prophylaxis in Addis Ababa after they receive their post test HIV result.
Methods: Prevention of Mother to child transmission of HIV program
uptake analysis was done among ANC attendants for Prevention of
Mother to child transmission of HIV –Voluntary counseling and testing
uptake and on the uptake for Nevirapin for all Prevention of Mother to
child transmission of HIV mothers and their newborns during two years
of Prevention of Mother to child transmission of HIV program
implementation at “Hareg” pilot sites by reviewing national registration,
recording and reporting formats. Qualitative study through in depth
interview with HIV positive mothers who lost from PMTCT program and
focus group discussion with health professional working at PMTCT clinic
and mother to mother support group were conducted to investigate the
women`s reasons for not accepting ARV prophylaxis in PMTCT program
in Addis Ababa at “Hareg” PMTCT pilot sites. Collected data were
translated, transcribed, prepared in Microsoft word document which is
changed to plain text. The document imported to Open code soft ware,
and coding, listing of frequencies, and data reduction were done. The
data then summarized. Interpretations of data, drawing of conclusion
were performed.
Result:- Total of 95378 new antenatal care attendants were registered
during this two-year period, of whom 44095 (46%) enrolled for VCT at the
PMTCT program and 28635 (65 %) tested for HIV. Three thousands four
hundreds and eighteen (3418) (11.9%)mothers tested HIV positive and
were therefore enrolled in the PMTCT program. However, only 1913 (56%)
HIV positive pregnant mothers received the Nevirapine during delivery.
Moreover: only 1965(57%) newborns received Nevirapine within 72 hours
after birth showing close to half of mother`s lost to follow up and didn`t
receive Nevirapin. Quality of health care during PMTCT counseling, follow
up, and delivery, stigma and discrimination were identified as the main
reasons for loose from PMTCT follow up and not took ARV prophylaxis
during delivery. Additional reasons mentioned includes personal factors
associated with the clients including religion related factors, distance
from facilities, changing of place and disclosure.
Conclusion and recommendation Strengthening monitoring and
Evaluation of PMTCT programs, mothers to mothers support group,
community mobilization, quality assurance program in PMTCT,
nutritional support and involvement of families in PMTCT program would
have paramount benefit in increasing ARV prophylaxis uptake.
Key words: PMTCT, ARV prophylaxis, Mother to mother , Nevirapin
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Keywords
PMTCT, ARV prophylaxis, Mother to mother, Nevirapin