| dc.description.abstract |
Abstract – Early Infant Diagnosis (EID) is the practice of testing
babies for the HIV virus within the first 4–6 weeks of life or at
the earliest opportunity thereafter. In order to correctly inform
caregivers the HIV status of their infants, and link HIV-infected
infants to care and treatment, a 'cascade' of events must
successfully occur. This cascade of events involves early
detection, and retention into care and treatment protocols.
The current study aimed at assessing maternal factors
influencing seeking of EID of HIV services in selected hospitals
in Nairobi County. More specifically, caregiver-level factors
were assessed to establish maternal perceptions towards EID
service delivery, knowledge, attitudes and practices. The study
was conducted at Mathare North Health Center, Mbagathi
District Hospital and Kibera South Health Center in Nairobi
County, which serve the catchment area of Kibera, Kawangware
and Mathare slums. Qualitative data was collected using Focused
Group Discussions (FGDs) guide.
Six FGDs were conducted with women of different age-groups,
two FGDs in each of the 3 selected facilities. Trained local
facilitators were used to conduct the FGDs in Swahili. All FGDs
were audio-taped, transcribed, translated and stored safely in a
computer. FGDs were discussed and interpreted using the Health
Belief Model (Tarkang & Zotor, 2015) and presented according
to the emerging themes. The findings of the study were used to
inform ways of improving infant health outcomes as they go
through the EID program.
Some of the key findings of the study were that: mothers
appreciated having the EID program as it ensured that their
infants got ART prophylaxis. Additionally, the mothers got
counselling services from the providers on how to reduce
MTCT. Some of the challenges the mothers cited included;
stigma and discrimination from their partners, family members
and neighbors, long waiting times while seeking EID services,
difficulty in disclosure of status to their significant others and
lack of funds to cater for transport costs to the healthcare
facilities to attend their scheduled clinics. Gaps in knowledge
were also identified from the focus groups such as lack of
adequate knowledge in prophylaxis dosing for their infants and
feeding methods.
Recommendations given by the mothers during the focus groups
included; improved counselling for partners to reduce stigma and
discrimination, provider assisted disclosure and provision of
funds to cater for transport costs. We recommend that maternal
education to be heightened during PMTCT and EID through
rigorous educational packages for HIV positive mothers and
their partners to reduce stigma and discrimination. Additionally,
telephone reminders and home visits would enhance adherence
improving infant health outcomes
Use of qualitative methods are a critical component to better
understand why ART eligible mothers choose not to initiate their
infants into the EID program on time or continue with treatment
to achieve desirable infant health outcomes. |
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