Status of Prevention of Mother-to-Child Transmission (PMTCT) Services Utilization and Factors Affecting PMTCT Service Uptake by Pregnant Women Attending Antenatal Care Clinic in Selected Health Facilities of Afar Regional State, Ethiopia

Abstract

Mother-to-child transmission (MTCT) is the predominant way for children to acquire human immunodeficiency virus (HIV) infection worldwide including Ethiopia. Thus, objective of this study was to determine the status of prevention of mother-to-child transmission (PMTCT) services utilization and factors affecting PMTCT utilization in health facilities of Afar region, Ethiopia. A cross-sectional study was conducted from December 2014 to April 2015 taking 347 pregnant women and 22 health care providers. Data were collected using a questioner prepared separately for pregnant women and health care providers involved in PMTCT service delivery. Data were analyzed using SPSS considering P value <0.05 statistical significant. The study indicated that the PMTCT service utilization was 67.7%. The study also showed that there is statistically significant association in using PMTCT service with women education level, monthly income, and residence around PMTCT site. Though not statistically significant, excess waiting time, limited physical access to PMTCT sites, and transportation problem were identified as barriers for PMTCT service utilization by pregnant women. Though knowledge of mothers on MTCT of HIV and PMTCT service utilization in agropostural community of Afar region was promising, there were also different barriers identified hindering PMTCT utilization. Thus, we recommend “Wored” and zonal health office to create awareness on significance of PMTCT service in the community, enhance accessibility of PMTCT sites, provide up-to-date trainings for health care providers, and ensure constant supply for PMTCT service.

Barriers to the management of children under five exposed to HIV in the rural areas of South Africa

“…This means both groups were missing opportunities to benefit from the PMTCT services because of lack of transport and financial constraints. This finding concurs with other studies (Akal & Afework 2018 ; Ashaba et al 2017 ; Frost et al 2017 ; Rodriguez et al 2017 ) which found that participants had financial and transport problems, and as a result did not go to clinic and some women gave birth at home. These situations should be avoided because there is a high risk of MTCT when women give birth at home without a healthcare worker, compared to those who deliver in the healthcare institution (Koye & Zekele 2013 ).…”

“…Some women resort to extreme measures, such as deciding not to attend ANC at all to escape having to do an HIV test because of the fear of stigma. In their research, Yah and Tambo ( 2018 ), Akal and Afework ( 2018 ), Fondoh and Mom ( 2017 ) and Cataldo et al ( 2017 ) found that fear of stigma, discrimination and rejection, divorce, physical abuse and violence were preventing a majority of women in PMTCT programmes to disclose their HIV status to their partners or families. This behaviour shows that stigma continues to threaten the success of managing HIV-exposed children under five in rural communities.…”

“…In this review, some of the healthcare workers openly acknowledged that their knowledge of MTCT was inadequate (Wilford et al 2018 ). Previous researchers (Akal & Afework 2018 ; Fondoh & Mom 2017 ; Nkomo et al 2015 ; Suryavanshi et al 2018 ) have highlighted that there is a lack of training of healthcare providers on PMTCT guidelines. It is therefore imperative that healthcare workers are continuously trained to stay abreast of relevant information for best practices in managing HIV-exposed children under 5 years old.…”

Lost to Follow-up and Predictors Among HIV-Exposed Infants in Northwest Ethiopia

“…This finding is supported by previous studies conducted in Brazil [ 11 ] and Zambezia, Mozambique [ 28 ]. Possible reasons for this difference may be due to distance from a health facility [ 29 , 30 ], inaccessibility of transport [ 31 ], poor transport infrastructure [ 32 ], economical reasons for transport, and high working burden in the house for mothers [ 33 – 35 ]. Another issue that might affect this service utilization relates to fear of stigma and discrimination, which particularly affects the rural community [ 31 ].…”

“…Possible reasons for this difference may be due to distance from a health facility [ 29 , 30 ], inaccessibility of transport [ 31 ], poor transport infrastructure [ 32 ], economical reasons for transport, and high working burden in the house for mothers [ 33 – 35 ]. Another issue that might affect this service utilization relates to fear of stigma and discrimination, which particularly affects the rural community [ 31 ]. Fear of stigma and discrimination could affect people in many ways; it may cause mothers to go far to find a health facility and the might decide to miss frequent visits to the health facility.…”