“Do PMTCT programs leak by design or default?" : examining the barriers to utilization of prevention of mother-to-child transmission of HIV services in Rift Valley Province: Kenya
Document type: mthesis
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Abstract:
PURPOSE: This study has been conducted as partial fulfillment of the requirement for the degree of Master of public health. BACKGROUND: Although there are on-going efforts to scale up Prevention of Mother-to-Child Transmission (PMTCT) services, the coverage and utilization still remains low. The enrolment into PMTCT programs is sub-optimal, the uptake of HIV counseling and testing is low and there is a high drop-out rate from follow-up. The coverage of ARV prophylaxis is low and the adherence is unknown. Overall the effectiveness of PMTCT programs in HIV transmission risk reduction is unknown at population level. OBJECTIVE: To identify and describe the factors that influence the utilization of prevention of mother-to-child HIV transmission services and the interventions that have been tried in other settings in order to improve the PMTCT program in Rift Valley province. The focus on barriers to HIV counseling, testing and uptake of ARV prophylaxis for both mother and infant. SETTING: Rift Valley Province in Kenya. METHODS: Use of literature review and presentation of PMTCT routine service delivery data from districts of Rift Valley Province. FINDINGS: Rift Valley province PMTCT program also suffers low utilization with high client loss to follow-up and unknown effectiveness of HIV transmission risk reduction. The barriers to access and use of PMTCT services are policy, institutional and cultural in nature. They include inadequacy of physical infrastructure and acute staff shortage to deliver services; challenges in the supply systems and unmet training needs of the health staff; Socio-cultural tendencies to stigmatize HIV positive women, lack of community awareness, involvement and participation in PMTCT programs and Health care systems’ lack of responsiveness to the needs of PMTCT clients. CONCLUSION: Despite the considerable constraints and challenges the PMTCT program in Rift Valley province can be improved by implementing innovative methods to address the human resource crisis, expand on its out-reach clinic services, improve on ANC coverage, institutionalize routine HIV testing, integrate PMTCT into reproductive health and mother child and newborn services, consider scaling-up use of combination ARV prophylaxis and strengthen its commodity and supply systems.
Authors:
Osumba, B.M.
Country:
Kenya
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
HIV and AIDS
,
disease prevention and control
,
maternal and child health
,
health services
,
reproductive health
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
67
Year:
2009
Region:
East Africa
Right:
© 2009 Osumba
Subject:
Health and Nutrition
Title:
“Do PMTCT programs leak by design or default?" : examining the barriers to utilization of prevention of mother-to-child transmission of HIV services in Rift Valley Province: Kenya
Training:
Master of Public Health / International Course in Health Development (ICHD)