Factors Influencing The Utilization Of Prevention Of Mother–to-child Transmission (PMCTC) Services Among Pregnant Women Attending Clinic

Factors Influencing The Utilization Of Prevention Of Mother–To-child Transmission (PMCTC) Services Among Pregnant Women Attending Clinic

Chapter One

Preface

Background to the Study

mortal Immunodeficiency Contagion/ Acquired Immune Deficiency Syndrome( HIV/ AIDS) has a ruinous goods and is presently a complication of gestation worldwide with further than 700,000 children infected annually. mama – To – Child Transmission( MTCT) of the contagion is responsible for further than 90 of these cases in children under 15 times( United States AIDS, 2012).

mama – To – Child Transmission( MTCT) of HIV can do during gestation, labour and delivery, or breastfeeding. During gestation, about 5 – 8 of babies come infected through transmission across the placenta. Labour and delivery pose the topmost threat for transmission( 10 – 20 of exposed child). Breastfeeding also exposes the child to HIV transmission particularly if dragged ( 18- 24 months). The fresh threat of HIV infection when and child is bone fed is around 15- 25 World Health Organization( WHO, 2013) in collaboration with othernon-governmental association like global fund, chairman’s exigency plan for Aids relief( PEPFAR)etc.

doable and affordable interventions now live to reduce the rate of MTCT by 50( Population Reports, 2010). The Prevention of mama – To – Child Transmission( PMTCT) protocol begins atpre-test comforting continues through the HIV test, result and registration for the intervention and at sanitarium delivery.

Sanitarium delivery ensures that both mama and baby admit the intervention( Nevira Pine) at the time. motherly Nevirapine is administered at the morning of labour, while the baby cure is given within 72 hours after delivery.

In 2012, around 400,000 children progressed under 15 came infected with HIV( UNAIDS, 2013). nearly all of these infections do in low and middle- countries, and further than 90 are the result of mama- To- Child- Transmission during gestation and delivery or breastfeeding. Without interventions, there’s a 20- 45 chance that a baby born to a HIV- infected mama will come infected( De Cock et al; 2011).

In 2006, the proportion was 23 and by 2009 an estimated of 53 of pregnant women living with HIV in low and middle income countries entered antiretroviral medicines to help HIV transmission to their babies World Health Organization/ United Nations International Children Fund( WHO/ UNICEF, 2011).

In Southern African where HIV is veritably wide among pregnant women, Botswana leads the way. High quality PMTCT services are handed in all of the country’s public installations through the motherly and child health/ family planning system which serves over 95 of the pregnant women( US Global Aids, 2012).

Sub-Sahara African has continued to bear the topmost burden of the HIV/ AIDS epidemic. Seventy percent of the estimated37.8 million people living with HIV, 70 percent of the4.8 million are new infections, 77 percent of the2.9 million are HIV deaths and 90 percent of the2.1 million children infected with HIV in 2003 were fromsub-Saharan African. 630,000 children were infected with HIV, and out of these, 90 percent passed isSub-Saharan African.

The high frequence of HIV in women of reproductive age group and the high fertility rates contribute to the comparatively high frequence of transmission of HIV to babies. The high frequence of MTCT of HIV is hanging to reverse the earnings of the child survival strategy in the African mainland( Federal Ministry of Health,( FMOH, 2010).

In Nigeria, the frequence of HIV infection among pregnant maters is estimated at 30 and is reversing the recent earnings of child survival programmes, thereby adding child and child mortality rates at Chiroma Ward in Lafia Local Government Area of Nasarawa State( FMOH, 2013). This has needed the proliferation of forestallment of mama – To – Child – Transmission program spots from 11 in 2002 to 622 in 2013( Chiroma Ward in Lafia Local Government Area of Nasarawa State, 2009). In March 2010 there was presidential directive to increase content of forestallment of mama – to child – to 30 by the end of 2010 and 50 by 2013, grounded on 2011 WHO recommendations, Chiroma Ward in Lafia guard report have indicated loftiest HIV frequence(10.6). It’s estimated that 7,620 pregnant women are infected with HIV Lafia Ministry of Health, 2013). About 2,000 babies are infected with HIV from their maters annually in the study area.

A aggregate of 438 HIV positive maters enrolled for the PMTCTAnte-natal Clinic in 2012 at Chiroma Ward in Lafia Local Government Area of Nasarawa State and are heirs of the PMTCT programme, out of the 438, only 337 continued attending the prenatal clinic to the end. Studies have indicated shy comforting and powerhouse at different service delivery points in enforcing PMTCT protocol, posing the need for exploration to find reasons for similar action( Madaki, 2015).

Combs( 2013) set up that MTCT knowledge was deficient, as those canvassed stated that all maters transmit HIV to their babies through bone feeding. maters warrant information on the forestallment of transmitting of HIV from an infected mama to her child, as well as measures that live to reduce the threat of transmission. Combs( 2013) concluded that health care workers demanded fresh MTCT training and support accoutrements to enable them to give comforting, applicable information and advice to guests about HIV and breastfeeding options.

HIV in children is a major problem in developing or coffers poor countries. About 277,000 children live with HIV representing 11 of the global pediatric HIV burden in Nigeria. Also over 65,000 to 117,000 of HIV infected children are delivered annually. About 8 of child mortality is related to HIV infection. This is a result of failed perpetration Prevention of Mother to Child Transmission( PMTCT)( FMOH, 2013). In Chiroma Ward in Lafia Local Government Area of Nasarawa State, the frequence of HIV infection in pregnant women is estimated at 24,620, over to 1868(1.04 statistically insignificant) entered antiretroviral for prophylaxis.

There were 3,328(1.86) HIV positive pregnant women entering child feeding comforting and support( Federal Ministry of Health, 2012). This reversing the recent earnings of child survival programme thereby adding child and child mortality rates. Defaulting sanitarium movables can be attributed to so numerous factors, similar as finance, wrong quality of service, transportation etc. therefore it’s important to carry out this study so as to unveil the quality of services offered by PMTCT clinic as perceived by guests attending the services which will go along way to reducing the prevalence of HIV/ AIDS in Chiroma Ward in Lafia Local Government Area of Nasarawa State.

Understanding guests perspectives would also help to know whether the services are being delivered in agreement with their requirements and if not also the need to enhancement.

Statement of the problem

The burden of HIV infection has now come a burning issue word wide peak. An estimated million people are now living with the contagion on earth earth with 2,000 babies getting infected daily. maturity of all new infections in different setting have helped reduce the HIV infections rate. The public HIV zero frequence has proven that the infection does yield to determined and connected intervention.

Worldwide, roughly2.2 million women and 600,000 babies are infected with HIV each time( UNAIDS, 2012). Since the first pediatric AIDS case was proved in 1985, the number of infected children has increased markedly, and the health care for these children is getting an adding burden on the public health system( Philips, 2013). As a result, PMTCT programme was initiated. PMTCT live in different corridor of the world including Nigeria. The services which include VC, HIV testing, ART, obstetric intervention( cesarean section) and safer child feeding( Abrams, 2014) are available in different corridor of the world.

Johnson( 2014) maintained that successful perpetration of PMTCT programme for a larger number of women are doable if the health system has acceptable coffers and labor force. This implies that vacuity and acceptable application of the services will reduce or exclude the threat of MTCT of HIV. Unfortunately, literature has shown that several factors stymie the vacuity and application of PMTCT. By recrimination, one may be tempted to mistrustfulness the vacuity and acceptability of PMTCT coffers and the position of application of these services by pregnant women. Skinner( 2015) set up out that several conventions that give the services to the original population were formerly unstaffed andover-pressured. But it’s an accepted fact that vacuity and acceptability of coffers are important in the application of PMTCT services.

Nigeria’s 2005 HIV zero- frequence rate of4.4 through an enhancement over the 2003 rate us still too high and inferior. During the time 2004 in Nigeria alone about 100,000 babies were likely to contract HIV from their maters ( UNAIDS, 2011).

The PMTCT intervention remains the only sure and doable stopgap in the problems of early child HIV opinion. thus, to lay important emphasis on forestallment rather than watch and treatment, in a nutshell the topmost unmet need remains the PMTCT of HIV( UNAID, 2011).

Purpose of the Study

The purpose of the study is to assess the Factors impacting the Application of Prevention of mama – To- Child Transmission( PMCTC) Services among Pregnant Women attending Clinic at Chiroma Ward in Lafia Local Government Area of Nasarawa State. Specifically, it seeks to

1) Determine the progressive position or perpetration of PMTCT at Chiroma Ward in Lafia Local Government Area of Nasarawa State.

2) Identify the number of available professed force for the perpetration of PMTCT.

3) Identify the number of guests patronage at the PMTCT services at Chiroma Ward in Lafia Local Government Area of Nasarawa State.

4) Determine the Factors affecting PMTCT of HIV and AIDS services.

Significance Of The Study

Health workers and parents may find the information on the factors impacting the Application of Prevention of mama – To- Child Transmission( PMTCT) services useful to check whether their original hospitals give full PMTCT programme and to press for enhancement in line with the recommendations that will be made for the benefits of maters of child bearing age and their babies.

The information may also be helpful to sanitarium directors to reorganize and train their staff for full PMTCT programme perpetration in their hospitals in realizing their liabilities in health care provision for pregnant women especially those that are seropositive and their children who vertically acquired the HIV.

The findings generated on the vacuity of PMTCT services may help pregnant women to know the hospitals that give the services. This will help to increase the position of application of the services by the target group and there will be enhancement on quality of life.

The information will also help service providers to consolidate public enlightenment programme on the need for HIV positive pregnant maters to make use of the services. The data generated may help to see the need to establish further PMTCT spots.

The findings attained from the vacuity of good of PMTCT service providers will help sanitarium directors in planning and using multiple approaches to training and retraining the service providers to ameliorate on their chops. The data may also give base to retain good staff for rendering PMTCT services in their hospitals.

The findings will help sanitarium directors to grease procurement of further accoutrements for PMTCT. Donor agencies may also be motivated to land these accoutrements for the hospitals. The data may also help the hospitals operation to solicit for material help from World Health Organization.

The information on the acceptability of good PMTCT service providers will help sanitarium operation to train more PMTCT service providers. The information may also help the government to circumscribe service providers from migrating to other countries for job. This will always place a check on brain drain in the county.

By furnishing information on the acceptability of PMTCT accoutrements , service providers will be motivated and encouraged to produce mindfulness to pregnant women for maximum application of the services. The government will accelerate action to achieve the thing of barring HIV infection in babies and youthful children.

The information generated will help the service providers to be motivated to produce mindfulness in pastoral areas to give bases for pregnant women to attend prenatal care. This may also help hospitals operation to know the capability of workers in their hospitals which may encourage training and retraining of their staff for that purpose.

The data attained from the position of application of HIV testing service may be an eye nature to service providers to be propelled to consolidate strategies for pregnant maters to willingly accept HIV testing. This may also help to motivate the colorful sanitarium directors to make available all the outfit and accoutrements necessary for HIV testing service in their hospitals. More so, their laboratory scientist may be retrained for HIV testing.

The findings generated may also help health care providers to support for community rallying sweats to increase acceptance of ART for PMTCT. It’ll also help to bring about trouble to support global sweats to negotiate reduced costs of the medicines and foster hookups among associations to buy medicines inclusively at low cost.

The information may also help health care providers to give community education about the significance of prenatal care and deliveries supported by MTCT- trained attendants.

The information on the position of application of safer child feeding options will help service providers to counsel HIV positive pregnant maters to make an informed decision concerning safer feeding option for their babies. Informed and safer choice may promote and increase quality of life of babies born to HIV positive maters .

The information will help PMTCT service providers to continually ameliorate their services and the way they work and to ameliorate the collaboration of PMTCT programme which will lead to changes in the process of preventative service delivery in practice. They will use the information in decision timber and in carrying out their liabilities in multiple practice association for HIV cases.

It’ll also give an occasion for enhancement of the services handed and increase the knowledge of the community on the vacuity of PMTCT services. Its package and intervention strategies will help to disband some incorrect beliefs and practices on the use of antiretroviral medicines( ARVS) that encourage or promote HIV/ AIDS transmission.