Presentation Title

Impact of the Elimination of Mother-to-Child Transmission of HIV Program at St. Francis Health Care Services in Uganda: Factors Affecting the Program and Avenues for Improvement

Faculty Mentor

Richard Mora

Start Date

17-11-2018 1:45 PM

End Date

17-11-2018 2:00 PM

Location

C304

Session

Oral 3

Type of Presentation

Oral Talk

Subject Area

health_nutrition_clinical_science

Abstract

Objectives. The goal of this study was to do a community based participatory research that plans to assess the value and impact of the Elimination of Mother-to-Child transmission of HIV (EMTCT) program at St. Francis Healthcare Services in Uganda, with the aim of improving it through direct feedback from the community of women, health care workers, and others taking part in the program. Methods. A qualitative research design was utilized to collect data through focus group discussions, in-depth interviews, and a survey focused on active EMTCT participants. In addition, in-depth key informant interviews (with health care workers, monitoring and evaluation staff, and husbands of active EMTCT participant mothers) were carried out. Results. The study identified institutional, patient level, as well as social level factors and challenges that affect the provision of EMTCT services at St. Francis. The major challenges within each are; (1) patient level factors– lack of money for transport, being sick…etc. (2) social level factors– Stigma, social networks, and gender roles (low levels of HIV disclosure to partners and male partner involvement) (3) institutional– access to comfortable space exclusive to EMTCT mothers. Discussion and Conclusion. Community-level factors (especially fear of disclosure, lack of male partner support, social factors, and stigma,) pose significant barriers to optimal uptake of EMTCT services. To achieve elimination of MTCT, interventions must work within communities to address barriers that have been identified and increase service use.

Summary of research results to be presented

Our results show that there are some significant barriers to optimal uptake of EMTCT services that occur at community level (i.e., outside the healthcare setting) that present priority focus areas for St. Francis.

Gender roles need to be addressed to ensure equitable HIV/AIDS health service expansion, particularly in EMTCT programs. Inequality in Gender roles with respect to barriers in EMTCT at St. Francis, also seemed to relate to other challenges that were observed such as, (i) challenges of disclosure of status to partners (ii) male partner involvement (iii) access to services(with regard to being dependent on male partners for transport money), and (iv) adherence to prescribed medication.

The results reveal that male partner involvement is an important priority area to work on for the EMTCT program in St. Francis. Male partner involvement is also difficult to achieve since there is a significant gap in the amount of mothers that disclose their status to their husbands. This poses a significant barrier in effectiveness of the program, since failure of an HIV positive woman to disclose her status to her partner and lack of male partner involvement in EMTCT interventions have been identified as two social factors that hinder the success of programs aimed at achieving EMTCT.

Both disclosure of HIV status and male partner involvement are affected by social perceptions and stigma. Some participants, who reported having good social networks through a supportive and understanding community, had also disclosed their status to their partners.

Overall, to achieve elimination of mother-to-child transmission of HIV, interventions must work within communities to address barriers that have been identified in order to increase service use. Therefore, efforts to improve the EMTCT program at St. Francis can be guided by the community input exacted through the process of this study.

This document is currently not available here.

Share

COinS
 
Nov 17th, 1:45 PM Nov 17th, 2:00 PM

Impact of the Elimination of Mother-to-Child Transmission of HIV Program at St. Francis Health Care Services in Uganda: Factors Affecting the Program and Avenues for Improvement

C304

Objectives. The goal of this study was to do a community based participatory research that plans to assess the value and impact of the Elimination of Mother-to-Child transmission of HIV (EMTCT) program at St. Francis Healthcare Services in Uganda, with the aim of improving it through direct feedback from the community of women, health care workers, and others taking part in the program. Methods. A qualitative research design was utilized to collect data through focus group discussions, in-depth interviews, and a survey focused on active EMTCT participants. In addition, in-depth key informant interviews (with health care workers, monitoring and evaluation staff, and husbands of active EMTCT participant mothers) were carried out. Results. The study identified institutional, patient level, as well as social level factors and challenges that affect the provision of EMTCT services at St. Francis. The major challenges within each are; (1) patient level factors– lack of money for transport, being sick…etc. (2) social level factors– Stigma, social networks, and gender roles (low levels of HIV disclosure to partners and male partner involvement) (3) institutional– access to comfortable space exclusive to EMTCT mothers. Discussion and Conclusion. Community-level factors (especially fear of disclosure, lack of male partner support, social factors, and stigma,) pose significant barriers to optimal uptake of EMTCT services. To achieve elimination of MTCT, interventions must work within communities to address barriers that have been identified and increase service use.