Socio demographic characteristics, antenatal clinic attendance and PMTCT knowledge of postnatal HIV+ women at an urban public health facility in Nairobi, Kenya
Loading...
Date
2015
Authors
Imbaya, C.U.
Odhiambo-Otieno, G.W.
Okello--Agina, B.M.
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University School of Medicine
Abstract
Background: Women who have
inadequate or poor knowledge
about Prevention of Mother to Child
Transmission (PMTCT) of Human
Immunodeficiency Virus (HIV) are more
likely to default on antiretroviral treatment
and less likely to implement MTCT
preventive measures thus a sub-optimal
viral suppression and an increase in
MTCT rates. Early and frequent Antenatal
Clinic (ANC) attendance integrated
with PMTCT services increases MTCT
knowledge and uptake of the services thus
optimising intervention outcomes.
Objectives: To determine the sociodemographic
characteristic levels that
influence Antenatal Clinic (ANC)
attendance, PMTCT knowledge and
Antiretroviral (ARV) drugs uptake among
postnatal HIV+ women.
Setting: Pumwani Maternity Hospital in
Nairobi, Kenya.
Methodology: This was a cross-sectional
descriptive study that was conducted at
Pumwani Maternity Hospital which is
in a low social income set up in Nairobi
County. The hospital has active ANC
and Postnatal Clinic (PNC) facilities that
provide PMTCT and specialist referral
obstetric services to more than 30,000
maternity clients annually. HIV+ positive
postnatal women who were seeking health
services at the hospital were identified
using their health records and recruited
into the study either while still in the
postnatal ward after delivery or during
post natal clinic visits within the period
of the study. Standardized structured
questionnaire was administered to collect
the appropriate study data from the
mothers.
Results: A total of 326 HIV+ women,
aged 15 - 42 years (mean 28.3 years)
participated in the study. Most of the
women were either married (72.9%), single
East and Central Africa Medical Journal 2015; 2(1): 10-17 10
(15.7%), widowed (6.8%) or separated
(4.6%) and of low levels of education.
Majority were either housewives (38.3%)
or engaged in small businesses such as
selling vegetables and merchandising
food items and second hand clothes. Their
overall estimated monthly mean domestic
expenditure was about US$ 102. Most of
the women (92.4%) attended antenatal
clinic in peripheral health facilities and
only came to PMH for delivery services.
Majority (94.5%) of the women received
Counselling and Testing (CT) while a
few (3.3%) reported being counselled but
not tested at the antenatal clinic. Among
the women who were counselled but
not tested for HIV antenatally majority
(81.8%) declined to be tested due to
fear of being told that they were HIV+.
They learnt about their status later after
delivery when they were convinced to
undertake the test. Regarding knowledge
about MTCT 94.7% ofthe women agreed
that they were aware that HIV can be
transmitted from the mother to her child
by various methods. Some of the women
(14.1%) were not aware that abstaining
from breastfeeding can prevent MTCT
and almost half of them (45.7%) did not
know that exclusive breast feeding was
also another preventive measure. Almost
15% of the mothers were not aware
that they could prevent MTCT by using
ARV's. Some of the women (15%) had
not informed their husbands regarding
their HIV status. However we did not
establish any significant relationship
between the husband's knowledge of
the wife's HIV status and the women's
acceptance to use ARV's. There was also
no significant relationship between the
husband's consent and women's decision
to use ARV's whereas most of the women
(99.3%) confirmed that they would take
the ARV's regardless of whether their
husband agreed to the usage or not. The
ARV adherence was not influenced by
the number of ANC visits, parity, education status and
husband's lack of awareness about the wives' HIV status.
Data on ANC attendance indicated that majority
(91.1 %) ofthe women attended ANC at it~1',~one or more
times either in the peripheral facilities or at Pumwani
Hospital but most (66%) made the first visit in the 5th
to 7th month (average 6th month) of gestation. HighANC
attendance rate was significantly associated with the
uptake of prophylactic ARV's (1)=0.001). The frequency
of ANC attendance was also significantly associated with
the health facility where the mother attended the clinic
(P=0.0045). Almost half (46.6%) of the women made
only 1 to 3 ANC visits. Reasons for not attending ANC
included not wishing to attend (66.6%), not knowing
the importance of ANC (16.7%) and far distance to the
clinics (16.7%).
Conclusion: The main gaps that were observed in this
study are the late initiation and low frequency of ANC
attendance, low PMTCT knowledge and delayed first
visit and uptake of ARV's among HIV+ women in this
low socioeconomic set up. This calls for improvement
of health services and community oriented PMTCT
education in the peripheral health facilities where the
bulk of ANC activities took place.
Description
This article was scanned from a hard copy of the East and Central Africa medical journal Vol.2 no1 2015
Keywords
HIV, ANC, PMTCT, ARV's
Citation
East and Central Africa Medical Journal 2015; 2(1): 10-17