Accessing Barriers and Determinants of Prevention of Mother to Child Transmission (PMTCT) of Human Immune Deficiency Virus (HIV) Services at Public Teaching Hospitals in Enugu State, Nigeria

Main Article Content

Umeobieri Ancilla Kate
Aniwada Elias Chikee
Obi Emmanuel Ikechukwu
Agunwa Chuka

Abstract

Introduction: The most effective means of reducing Mother-to-Child transmission of HIV is to provide suppressive HAART. Prevention of Mother to Child Transmission (PMTCT) directly affects the achievement of Sustainable Development goals just. The unmet need for PMTCT services in Nigeria, particularly in Enugu state, is unacceptably high. This study aimed to assess factors associated with access barriers and determinants to PMTCT services in public health facilities in Enugu, Nigeria.


Materials and Methods: The study design was a facility-based analytical cross-sectional study. HIV positive nursing mothers who were accessing PMTCT services were studied. Questionnaire was used. Chi-square test and Binary logistic regression was done to for determinants of experience of any access barrier.  Level of significance was determined at a p-value of ≤ 0.05.


Results: A total of 2275 participants were reported on. A higher proportion of participants were in 30-34 years age group 124 (45.1%), attained secondary education 144(52.4%) and provided for by their husbands 174(63.3%) The major barriers identified were; long waiting time at the facility 184(66.9%), distance of facility 161(58.5%), PMTCT being far away from other units/departments 155(56.4%), Health workers talking to the clients with no respect 151(54.9%), Stigma and discrimination from friends/neighbours 163(59.3%) and from health workers 123(44.7%) as well as being too busy with household chores 130(47.3%). There were statistically significant association between experience of barriers with age in categories (χ2=11.741, p =0.008), religion (χ2=5.381, p =0.020), source of income (χ2= 8.817, p=0.032) and ethnicity (χ2=9.240, p=0.026).


Conclusion: Over ninety percent of respondents experienced a form of barrier. The major barriers include; long waiting time, distance to facility, location of PMTCT units, Health workers attitude, Stigma and discrimination from health workers as well as being too busy with household chores. There was no identified predictor of access barrier.

Keywords:
Access, barriers, public tertiary facilities, PMTCT

Article Details

How to Cite
Kate, U., Chikee, A., Ikechukwu, O., & Chuka, A. (2019). Accessing Barriers and Determinants of Prevention of Mother to Child Transmission (PMTCT) of Human Immune Deficiency Virus (HIV) Services at Public Teaching Hospitals in Enugu State, Nigeria. International STD Research & Reviews, 8(1), 1-9. https://doi.org/10.9734/ISRR/2019/v8i130093
Section
Original Research Article

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References

Gayle HD, Hill GL. Global impact of human immunodeficiency virus and AIDS.
Availble:https://www.ncbi.nlm.nih.gov ›

Okagbue RN. An investigation into the factors affecting the utilization of mother to child transmission services by human immuno-deficiency virus positive women in Onitsha, Anambra State, Nigeria.
Available:uir.unisa.ac.za
Accesses 20/10/18

Nkwo P. Prevention of mother to child transmission of Human Immunodeficiency Virus: The Nigerian perspective. Ann Med Health Sci Res. 2012;2:56-65.

Arulogun OS, Adewole IF, Alli OL, Adesina AO. Community Gate Keepers, awareness and perception of prevention of mother-to-child transmission of HIV services in Ibadan, Nigeria. Afr J Reprod Health. 2007;11(1):67-75.

Lala MM, Rashid HM. Vertical Transmission of HIV. The Indian Journal of Pediatrics. 2010;7(11):1270

UNAIDS World AIDS Day Report; 2011. Available:http://www.unaids.org
Accesses 20/10/18

Hopra M, Lawn J, Sanders D, Barron P. Achieving the health millennium development goals for South Africa: challenges and priorities. Lancet. 2009; 374:1023–1031.

UNAIDS Nigeria Profile, HIV and AIDS in Nigeria; 2007.

Available:www.avert.org/aids-nigeria Accesses 20/10/18

UNAIDS/WHO, Question and Answer III, Duer, HIV and AIDS in Nigeria; 2005.
Available:www.avert.org/aids-nigeria Accesses 20/10/18

Auxilia M, Winfreda C, Keatinge J, Lynda SC, Godfrey W, Elizabeth M et al. Factors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe. Journal of International AIDS Society. 2010;13:38.

WHO. Prevention of mother-to-child transmission of HIV/AIDS programmes. Available: atwww.who.int
Accesses 20/10/18

UNICEF: Preventing Mother-to-child Transmission (PMTCT) of HIV factsheets on the status of national PMTCT responses in most affected countries; 2010.
Available:www.unicef.org/aids
Accesses 20/10/18

FMOH. National Guidelines on implementation of PMTCT; HIV/AIDS in Nigeria 2012; Abuja, Nigeria.

De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: Translating research into policy and practice. JAMA. 2000;283:1175–1182.

Painter TM, Diaby KL, Matia DM, Lin LS, Sibailly TS, Kouassi MK, et al. Women's reasons for not participating in follow up visits before starting short course antiretroviral prophylaxis for prevention of mother to child transmission of HIV: Qualitative interview study. Br Med J. 2004;329(7465): 543–6.

Chinkonde JR, Sundby J, Martinson F. The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: Why do so many women drop out. Reprod Health Matters. 2009;17(33):143–51.

Theilgaard ZP, Katzenstein TL, Chiduo MG, Pahl C, Bygbjerg IC, Gerstoft J, et al. Addressing the fear and consequences of stigmatization – A necessary step towards making HAART accessible to women in Tanzania: A qualitative study. AIDS Res Ther. 2011;8:28.

Etifit RE, Samson-Akpan PE. Utilization of antenatal and delivery services by pregnant women in Calabar Municipality, Cross River State, Nigeria. Nigerian Journal of Nursing. 2008;1:49-58.

Moth IA, Ayayo AB Kasaje DO. Assessment of utilisation of PMTCT services at Nyanza Provincial hospital, Kenya. SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance/SAHARA, Human Sciences Research Council [SAHARA]. 2005;2(2): 244-250.

Duff P, Kipp W, Wild TC, Rubaale T, Okech-Ojony J. Barriers to accessing highly active antiretroviral therapy by HIV-Positive women attending antenatal clinic in a regional hospital in western Uganda. Int J Womens Health. 2012;(4): 227-33.

Federal Ministry of Health, Nigeria. National HIV/AIDS and Reproductive Health Survey, Abuja: Federal Ministry of Health; 2005.

Nkonki LL, Doherty TM, Hill Z, Chopra M, Schaay N, Kendall C. Missed opportunities for participation in prevention of mother to child transmission programmes: Simplicity of nevirapine does not necessarily lead to optimal uptake, a qualitative study. AIDS Res Ther. 2007;4:27.

Laher F, Cescon A, Lazarus E, Kaida A, Makongoza M, Hogg RS, et al. Conversations with mothers: exploring reasons for prevention of mother-to-child transmission (PMTCT) failures in the era of programmatic scale-up in Soweto, South Africa. AIDS Behav. 2012;16(1):91–8