Factors influencing prevention of mother to child transmission (PMTCT) outcomes in the Rundu District of Namibia

Said, Mohamed (2014-04)

Thesis (MPhil)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Introduction: In Namibia, according to the National Sentinel Serosurvey 2012, the HIV prevalence among pregnant women attending antenatal clinic has increased from 4.2% in 1992 to 18.2% in 2012. A high HIV prevalence in women of reproductive age thus exists in Namibia and as a result the risk of vertical transmission of HIV from infected mothers to their new born is also high. Without any interventions, about 20-45% of exposed children will be infected with HIV. With an effective Prevention of Mother to Child Prevention (PMTCT) programme, the risk can be reduced to as little as 2%. Despite the international and national efforts to try to implement such interventions, some gaps and barriers still exist in many sub-Saharan Africa countries, including Namibia, posing a challenge to PMTCT programme roll out. This study attempts to identify these gaps and barriers in the Rundu district of Namibia, which has an HIV prevalence of 24.5%. Methodology: A qualitative study was done using the face to face interviews. The target population consisted of health care workers providing PMTCT and ART services at selected health facilities in the Rundu district. Findings and Recommendation: The study participants were very experienced in delivering PMTCT services and the majority has been working on the programme for more than five years. Some of the challenges identified include home deliveries, lack of male involvement and stigma surrounding HIV/AIDS and formula feeding. The main reasons associated with these challenges include lack of knowledge, cultural beliefs as well as poverty. Respondents also felt there is a lack of staff to attend to the high patient load experienced at their health facilities and that current staff should be re-trained more often. It was recommended that PMTCT programme strategies should be improved by putting measures in place to increase awareness around HIV/AIDS and PMTCT issues identified in this study.

AFRIKAANSE OPSOMMING: Inleiding: In Namibië het die MIV-voorkoms onder verwagtende vroue wat nageboorte-klinieke besoek het, volgens 2012 se National Sentinel Serosurvey, in 1992-2012 van 4.2% tot 18.2% gestyg. Daar is dus 'n hoë MIV-voorkoms onder vroue in die reproduktiewe ouderdomsgroep in Namibië en die risiko van vertikale oordrag van MIV vanaf geïnfekteerde ma's na hul pasgeborenes is gevolglik ook hoog. Sonder ingryping sal sowat 20-45% van die blootgestelde kinders ook MIV-geïnfekteer word. Doeltreffende PMTCT-programme kan dié risiko tot slegs 2% verminder. Ondanks die internasionale en nasionale pogings tot sulke tussentredes bestaan daar steeds tekortkominge en struikelblokke in vele Afrikalande suid van die Sahara, insluitend Namibië, wat 'n uitdaging bied om PMTCT-programme hier ingestel te kry. Dié studie poog om sulke tekortkominge en struikelblokke te identifiseer in die Rundu-distrik, Namibië, met sy MIV-voorkoms van 24.5%. Metodologie: 'n Kwalitatiewe studie is gedoen, wat die gesig-tot-gesig-onderhoude gebruik het. Die teikenbevolking was gesondheidsorg-werkers wat PMTCT- en ART-dienste by uitgesoekte gesondheidsorg-geriewe in die Rundu-distrik aanbied. Bevindings en aanbevelings: Die deelnemers aan die studie was goed vertroud met PMTCT-dienslewering en het meestal meer as vyf jaar met dié program gewerk. Onder die uitgekende uitdagings is tuisaflewering, die gebrek aan mans se betrokkenheid en die stigma rondom MIV/Vigs en formule-voeding. Die redes hiervoor hou meestal verband met onkunde, kultuurgelowe en armoede. Respondente het ook gemeen die personeel is onvoldoende vir die hoë pasiënt-ladings by hul gesondheidsorg-fasiliteite en dat die huidige personeel meer gereeld heropgelei moet word. Die instel van maatreëls vir beter programstrategieë rakende PMTCT is voorgestel, om groter bewuswording te bevorder rondom die MIV/Vigs- en PMTCT-kwessies wat in dié studie geïdentifiseer is.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/86659
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