Factors Influencing Prevention of Mother to Child HIV Transmission Program in Nakuru District, Kenya
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Date
2014-03-17
Authors
Mwangi, Jonathan Njogu
Journal Title
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Abstract
Each year, around 370,000 children aged 15 years and below become infected with HIV.
Almost all of these infections occur in developing countries, and more than 90% are the result
of mother-to-child HIV transmission. The infections can be averted through PMTCT activities.
Without interventions, there is a 20-45% chance that an infant born to an HIV -infected mother
will become infected. The study evaluated the management of PMTCT in Nakuru District with
an aimed of making a positive contribution in improving health services delivery in the district
and especially child survival efforts for wider scale application. The program (PMTCT)
provides the best chance to prevent HIV transmission to children. It was launched in Nakuru
District in the year 2002. The study was conducted in Nakuru District in six health facilities
namely: Nakuru Provincial General Hospital, Rongai Health Center, Bondeni Maternity,
Langalanga Health center, PCEA Nakuru West Health Center and Marie Stopes Dispensary.
The study methodology was comparative descriptive and analytical cross-sectional survey. It
was conducted in three phases: phase one: secondary data collection from the six sampled
health facilities: phase two: administration of questionnaires to 256 randomly selected ANC
expectant mothers and phase three: conducted six interview schedules to key informants and
six focus group discussions from health care workers from the six sampled sites aimed at
injecting qualitative information not captured through observation or the questionnaires.
Descriptive statistics was used to summarize the data while Statistical Package for Social
Sciences (SPSS) was used to analyze it. Cross tabulation was done to establish the relationship
between variables and Chi-square used to test the hypothesis which was accepted at p values
<0.05. The age of the respondents ranged from 15years to 44 years, 81.9% of the respondents
were married, 16.1% were not married, 1.6% separated and 0.4% divorce. About 40% had
secondary, 36.5% primary, 19.6% tertiary, 2.7% university and 1.2% other levels of education.
Respondents' monthly incomes showed that 19.5% earned <ksh 2000, 18% >ksh 2001>5000,
9.8% >ksh 5001 >10000,5.9% >ksh 10001 >20000 and 2% < ksh 20,000. The respondents'
occupation showed that 45.2% were housewives, 23% had businesses, 22.6% were employed
and 9.3% not employed. The percentage of mothers attending ANC clinic generally increased
significantly (p<0.001), while PMTCT awareness was 88.5%. However the awareness had no
significant facility association (p= 0.206) but the source of PMTCT awareness a part from
health care workers showed that media and friends gave significant input (p=0.003). Enrolment
to PMTCT increased significantly (p=0.018) while the percentage of mothers tested increased
from 55.3% in 2003 to 84.9% in 2007. The percentage of mothers and children put on ARV
prophylaxis increased significantly (P<O.OOl) and so was the mothers practicing exclusive
breastfeeding (p<0.000).ยท Among the factors that influenced PMTCT services was human
resource (p=0.000), accessibility of PMTCT services (p=0.00) and infrastructure. The study
determined that there was an increase in health seeking behavior in the district demonstrated by
consistent growth in the number of expectant mothers' visiting ANC clinic and their enrolment
to PMTCT services. Services are influenced by level of education, income, human resource and
infrastructure. A gap exists between enrolments and testing of the mothers in PMTCT. Lack of
well coordinated linkage and referral protocols influence the program negatively. There is need
for further research in the area. Frequent deliberate, robust and aggressive campaigns through
rapid response community mobilization initiatives and media are recommended as they will
assist in increasing PMTCT uptakes.
Description
Department of Public Health, 91p. The RG 580 A44M83 2009
Keywords
AIDS (Disease) --Kenya --Prevention, AIDS (Disease) in pregnancy --Kenya --Prevention, AIDS (Disease) in infants --Kenya --Prevention