Translating Research into Practice in Low-Resource Countries: Progress in Prevention of Maternal to Child Transmission of HIV in Nigeria

Abstract

Background. Research related to prevention of maternal to child transmission (PMTCT) of HIV is dynamic and rapidly changing and has provided evidence-based interventions and policies for practitioners. However, it is uncertain that research and policy guidelines are adequately being disseminated and implemented in resource-constrained countries with the largest burden PMTCT. This study examined current PMTCT practices in 27 public health facilities in Nigeria. Methods. A cross-sectional survey of 231 practicing nurses was conducted. Current PMTCT care practices were evaluated and compared to WHO and national PMTCT policy guidelines. Linear mixed models evaluated the association between PMTCT care practices and training in PMTCT. Results. Most nurses (80%) applied practices involving newborn prophylaxis; yet significant gaps in maternal intrapartum treatment and infant feeding practices were identified. PMTCT training explained 25% of the variance in the application of PMTCT care practices. Conclusion. Key PMTCT practices are not being adequately translated from research into practice. Researchers, policymakers, and clinicians could apply the study findings to address significant knowledge translation gaps in PMTCT. Strategies derived from an implementation science perspective are suggested as a means to improve the translation of PMTCT research into practice in Sub-Saharan African medical facilities.

The Effect of Training on Traditional Birth Attendants' PMTCT Related Knowledge and Care Practices in Nigeria

“…This has led to a broadening in the role of TBAs as care providers for mothers living with HIV in Nigeria. It is imperative for TBAs and similar cadre of health care providers in resource-limited settings to be knowledgeable and have the ability to deploy evidencebased care practices in PMTCT if the UNAIDS goal of an AIDS free generation will be achieved [3].…”

“…In public health, DOI theory is used to accelerate the adoption of public health programs which typically aim to change the behavior of a human system. Successful adoption of public health programs result from understanding the target population and factors that influence their rate of adoption [3,10,11].…”

“…Data collection instrument was adopted from a similar study among nurses in Nigeria [3]. Three Reproductive health specialists assessed the instrument for content validity.…”

“…The burden of MTCT transmission of human immunodeficiency virus (HIV) is highest in sub-Saharan Africa where majority of the estimated 350,000 infants who acquired HIV infection from their mothers reside [3,4]. Nigeria accounts for about 30% of the overall global burden of MTCT with more than 210,000 children living with HIV and an estimated 56,681 annual HIV positive births [5].…”

“…The successful linkage of evidence with practice in sub-Saharan Africa and other resource limited settings will translate into the reduction of MTCT of HIV as has been achieved in other parts of the world. Guidelines for the PMTCT which are based on up to date evidences exist all across sub-Saharan Africa including Nigeria [3]. However, it is pertinent for these guidelines to be strictly adhered to in order to make substantial progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) goal of eliminating vertical MTCT by the end of 2015.…”