Utilization of Early Infant Diagnosis Services by Caretakers of Infants in Selected County Hospitals in Kenya

Abstract

Introduction: Early infant diagnosis among human immunodeficiency virus (HIV)-exposed infants is critical for preventing mother-to-child transmission programs. The Kenya Ministry of Health recently revised their early infant diagnosis (EID) guidelines to align with World Health guidelines on managing HIV and treatment for infants. Despite these interventions to address barriers to IED, Kenya faces challenges in the uptake of EID. This study explored health outcomes of EID on HIV/AIDS and determinants of its utilization in selected level 4 and level 5 public health facilities in Kenya

Methods: A cross-sectional descriptive design was adopted for this study. A structured questionnaire was administered to 351 caregivers of infants presenting in level 4 and 5 hospitals in Baringo, Homa Bay, Kiambu, Machakos and Trans Nzoia counties of Kenya. The study also reviewed medical records for the caregivers and linked the medical records with the caregiver survey. The infants had been enrolled in comprehensive care clinics over for at least one year. Regression analysis and descriptive statistics were utilized in data analysis.

Results: Knowledge of EID services was 86.66%(n=351), of whom 25%(n=318) did not know about EID before delivery. 20% of caregivers reported they did not know a facility where EID services are offered during their pregnancy. 12.23% of the infants did not receive HIV prophylaxis after delivery. 78.3% of caregivers reported that they knew the benefits of EID. the main barrier to EID services is stigma and discrimination on HIV. Caregivers' age was associated with poor health outcomes (p= 0.004). Unemployment status, reduced number of times attending HIV counselling at MCH and attendance of ANC visits were associated with more poor health outcomes (p= 0.003, p=0.001 and p= 0.006), respectively

Conclusions and recommendations: While HIV knowledge among caregivers was high, knowledge of EID services were low in Kiambu and Trans Nzoia counties. The main barriers of EID services were stigma and discrimination and lack of awareness of availability of EID services in facilities. Therefore, interventions to increase awareness and address stigma are critical factors in increasing EID services' uptake and utilisation.