Determinants of Elimination of Mother to Child Transmission of Hiv among Patients at the Nakuru County Referral Hospital, Kenya
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Date
2022
Authors
Isindu, Boniface Ambani
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Globally, 37.6 million people living with HIV around the world, 67% live in sub-Saharan Africa. Out of the 200,000 new diagnoses of HIV in Africa in 2021, young women and adolescent girls aged 15-24 made up 27% of those new cases. The United Nations reported 1,000 new infections per week in this group. Regionally, out of the 20.7 million adults living with HIV in the region in 2018, 12 million were women: young women (aged 15–24 years) account for 26% of new HIV infections: In Kenya, tremendous progress in slowing down spread of HIV has been made with new infections declining by 68.4% between 2013 and 2021.Deaths attributed to HIV/AIDS had dipped by 67% from 58,446 people in 2013 to 19,486 in 2021.Increased number of people on life-saving antiretroviral treatment ;Rise by 83%, from 656,369 in 2013 to 1,199,101 in 2021 adults prevalence stands at 4.9%;Women at 6.6% twice that of men (3.1%) as per Kenya Population-based HIV Impact Assessment (KENPHIA) 2018 survey Mother to child transmission (MTCT) of HIV, is the main route of HIV infection among infants born by HIV positive mothers. An estimated 50,000 to 60,000 infants contract HIV infection annually in Kenya through their mothers .Kenya rolled out a countrywide Prevention of Mother to Child Transmission (PMTCT) programme to reduce the HIV infection in children because the main route for HIV transmission among children is through birth .In Kenya, an estimated 37,000 to 42,000 infants are infected with HIV annually due to MTCT.During pregnancy, about 5 to 8 percent of HIV-exposed babies become infected through transmission across the placenta. In Kenya, the national MTCT rate for the year 2021 was 3.2% while the rate in Nakuru County was reported to be 4..9% with the highest reported rate being in the month of march 2021 at 9.4%.Currently the MTCT rate reported in Nakuru county (4.9%) is much higher than the National rate (3.2%).The causes of this sustained high MTCT rate are not well documented hence this study at Nakuru County Referral Hospital to investigate these determinants. The Study objective was to investigate the determinants of eMTCT among patients at Nakuru county Level 6 Referral Hospital, Kenya. A cross sectional analytical research study was carried out with data collected from ANC mothers, key informants and FGD participants using structured questioners, key informant interview guides and FGD guides. The analysis of the data collected from the ANC clients revealed that nearly seventy percent of mothers had no knowledge of services provided to seropositive pregnant mothers to reduce the risk of transmission to unborn child. Further analysis revealed that low male involvement and participation, Stigma, and discrimination, peer pressure, social groups, religious sects, ceremonies (funerals), visiting sick people in the community were key social determinants that sustained high transmission rates in the county. Cultural beliefs, practices and taboos had a significant contribution to the high MTCT rates that were reported in the county. Low level of knowledge contributes significantly to the high MTCT rate reported in Nakuru Referral Hospital as were social cultural factors. It was recommended that Ministry of Health in collaboration with Health implementing partners and all health actors to develop promotional messages and information on eMTCT and disseminate them to all pregnant women attending ANC at all health facilities in the country. Socio mobilization and awareness on Prevention of Mother to Child Transmission program to be scaled up to empower women with knowledge on PMTCT. Community and political leaders to be enlightened by health implementing partners on good health practices to discourage pregnant women from their negative cultural beliefs and practices to promote health seeking behavior among these women. Health education and health talks to pregnant women to focus more on the importance of adherence to clinic appointments during their pregnancy life to benefit from services provided.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Monitoring and Evaluation) in the School of Public Health and Applied Human Sciences of Kenyatta University
Keywords
Determinants, Elimination, Mother, Child, Transmission, Hiv, Patients, Nakuru County, Referral, Kenya