ASSESSMENT OF AWARENESS OF PMTCT SERVICES AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC

CHAPTER ONE:

INTRODUCTION

1.1 Background of the study

Mother-to-child transmission (MTCT) of HIV remains a major public health problem and continues to account for a substantial proportion of new HIV infections among young children [Thara and Srinivasan 2000; Murphy 2002; Botha et al. 2006]. The delivery of HIV counseling and testing (HCT) services toward pregnant women for prevention of mother-to-child transmission (PMTCT) is one of the most important HIV prevention strategies. During the past decade, significant progress has been made in scaling-up PMTCT services to pregnant women, particularly in resource constrained countries [Kalua, 2017]. The risk of MTCT of HIV can be reversed through the detection of maternal infection during pregnancy and administration of antiretroviral (ARV) prophylaxis [4]Mother-to-child transmission (MTCT) is an important source of HIV infection among Nigerian children. To achieve the goal of reducing the number of infants with HIV, there has been a rapid scale-up of ARV prophylaxis and HCT services in the country since 2005 [Makoni, 2015]. All pregnant women are encouraged to access ANC services and receive information, preventive services, HCT, access to treatment and ARV for PMTCT. The national PMTCT guidelines is based on the four-pronged approaches and recommends an integrated PMTCT and HCT services within routine family planning and maternal, newborn and child, and reproductive health services at all levels. Rapid HCT services are offered free of charge to all pregnant women attending routine antenatal, delivery and post-natal services in the country, using the World Health Organization (WHO) guidance on provider-initiated HIV testing and counseling (the Opt-Out) in health facilities [Makoni, 2015]. Despite the progress made in the reduction of MTCT in Nigeria by increasing access of pregnant women to HCT services, the proportion of pregnant women receiving the PMTCT services has been low. A total of 90,311 HIVpositive pregnant women and 14,276 HIV-positive births were reported in the country in 2010/11 [Kalembo, 2013]. However, the proportion of pregnant women counselled and tested for PMTCT was 33.4%, and only 9.3% of infants born to HIVpositive mothers received ARV prophylaxis for PMTCT. There are a number of factors that contribute to the low uptake of PMTCT services. ANC, skilled birth attendant and HCT services influence the utilization of PMTCT for HIV. About 20% of the pregnant women in Nigeria do not attend ANC services. Even among women who attend ANC, most deliver at home due to lack of easy access to maternity services. In 2010/11, only 16.6% deliveries were attended by skilled attendant at a health institution [Kalembo, 2013]. A huge gap exists between ANC attendance and skilled attendance at birth. Studies identified various barriers to the implementation of PMTCT of HIV including socio-economic and cultural factors affecting the uptake of HCT services, initiation of ARV prophylaxis and lost to follow up after starting ARV for PMTCT. Therefore the study will examine the assessment of awareness of pmtct services among pregnant women attending antenatal clinic.

1.2 Statement of the problem

Every day there are nearly 1800 new HIV infections in children under 15 years of age, more than 90% occurring in the developing world. Most (about 90%) of these infections are associated with mother-to-child transmission (MTCT). Moreover about, 1400 children under 15 years of age die of an HIV-related illness per day. Poor male partner involvement in PMTCT services is one of the factors contributing to reduced effectiveness of the PMTCT and hence failure to achieve the elimination of maternal to child transmission of HIV. For this reason the study looks into the assessment of awareness of pmtct services among pregnant women attending antenatal clinic.

1.3 Objective of the study

The broad objective of the study is to look into the awareness of pmtct services among pregnant women attending antenatal clinic. The specific objectives includes:

1. To assess the knowledge of pregnant women on the mode of HIV transmission from mother to child.

2. To determine whether pregnant women have adequate awareness of PMTCT.

3. To ascertain the attitude of pregnant women towards PMTCT interventions.

4. To assess the possible preventive strategies for mother to child transmission of HIV.

1.4 Research Questions

The following questions have been prepared for he study

1. Do pregnant women have knowledge on the mode of HIV transmission from mother to child.?

2. Do pregnant women have adequate awareness of PMTCT?

3. What is the attitude of pregnant women towards PMTCT interventions?

4. What are the possible preventive strategies for mother to child transmission of HIV?

1.5 Significance of the study

This study will be beneficial to married men and women, single people, health practitioners and the government. Nonetheless, three are potential benefits to be had from some of the elements of ante-natal care, and these benefits maybe most significant in developing countries where mobility an mortality levels among reproductive-age women are high.

This study will serve as an existing material for further research and future reference.

1.6 Scope of the study

The study will assess the knowledge of pregnant women on the mode of HIV transmission from mother to child. The study will also determine whether pregnant women have adequate awareness of PMTCT. The study will further ascertain the attitude of pregnant women towards PMTCT interventions. Lastly, the study will assess the possible preventive strategies for mother to child transmission of HIV. Hence, the study is delimited to mother and child hospital Akure, Ondo State.

1.7 Limitation of the study

During the course of this study, the only limitation faced by the researcher was Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research