A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia

Abstract

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.

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

“…This study also revealed that health care related factors such as cost of the drug, not getting friendly service from health facility, and long waiting times were frequently mentioned factors for not continuing PMTCT service utilization. This is in line with findings of other study done in Ethiopia revealed that health workers are not happy to handle deliveries for women who are known HIV positive due to fear of accidental infection [22]. Other studies have also had similar findings [17,23,[28][29][30][31].…”

“…Frequently mentioned individual and family related factors identified in this study were fear of divorce, lack of family support, lack of partner support and lack of time. Like our research, other studies found that non-disclosure of HIV status, fear of divorce, fear of HIV stigma, and lack of partners support were some of the most common barriers to PMTCT service utilization [16,[19][20][21][22][23][24][25][26]. Another study in Sudan [27], and in Malawi [28] also revealed that women are not likely to disclose their HIV status due to stigma.…”

Assessment of Male Partner’s Involvement in Prevention of Mother-to-Child Transmission of HIV and Associated Factors Among Males in PMTCT Services

“…8%) were conducted in 2013 (28,35,40) and 3 (15. 8%) were conducted in 2012 (22,33,37). Two studies (10.…”

Patient-Reported Factors Facilitating Participation in Prevention of Mother to Child Transmission of HIV Programs in Kara, Togo, West Africa

“…HCWs were critical to helping build the motivation and resulting empowerment for women to adhere to the PMTCT program, through effective education regarding the efficacy of PMTCT. Nyasula and others found that shortage of HCWs in Malawi and other settings leads to inadequate PMTCT program education and inaccurate assessments of participants' situations [19] [20]. Ensuring that there are HCWs knowledgeable about and trained to deliver effective education as a core component of antenatal and HIV services will be important to achieving the patient motivation related to a belief in the promise of PMTCT.…”