The perceptions of pregnant women attending antenatal clinics in Qwa-Qwa, Free State, South Africa, regardin the PMTCT program
Thesis (MFamMed)--Stellenbosch University, 2009.
Background: The prevalence of cases of HIV among children below the ages of 15 years continues to increase and majority of these children acquired the infection through mother-to-child transmission. Methodology: The main objectives of the study were to explore the perceptions of local women regarding the PMTCT program, to evaluate the strength of these perceptions and to make recommendations. A qualitative method was used involving a number of focus group discussions among antenatal clinic attendees in the 27 primary health care clinics in Qwa-Qwa, Free State province of South Africa. Findings: The findings were organised under eight major themes: (1) Knowledge of the program -where the participants expressed high knowledge about the PMTCT program as they knew how MTCT of HIV occurs and how it can be prevented, (2) Perceived concerns about the program- which were mainly fear of resistance to ARVs, fear of stopping the treatment after delivery, potential for high numbers of orphans, depression and suicide when HIV result is positive, the fear of the family neglecting the baby if the mothers dies, the perception that the program cares for only the babies and not their mother, (3)Readiness to do HIV test- where majority of the participants said it was difficult doing the HIV test due to fear of positive result, (4) Ease of taking ARVs- Difficulty in taking the ARVs due to fear of resistance and harmful side effects, (5) Relationship with clinic staff- a majority of the participants were happy with their relationship with the clinic staff, (6) Reactions expected from family members when program advice is followed- more than half of the participants expected negative reactions from family members if the program advice is followed because of the negative attitudes of their male partners and the elders’ of the resistance to change from their cultural beliefs, (7) Advantages of the program- according to the focus group participants, the advantages of the program include the knowledge gained about HIV, modes of MTCT of HIV and how to prevent MTCT of HIV. Other advantages mentioned were prevention of MTCT of HIV, pre-test counselling reducing the fear of doing HIV test, knowing one’s HIV status as well as the potential of the program to have positive change on the cultural beliefs of the people, and lastly (8)How they felt being part of the program- where all the participants said they were excited . Conclusions: The findings were similar to those of other studies in many respects. Recommendations: The recommendations were community and family HIV/AIDS education and their involvement in the PMTCT program in other to reduce misconceptions about the disease, and stigmatization against the women in the program. Other recommendations include: the concept of PMTCT-plus which provides ongoing support and treatment for the mothers, babies and infected family members; integration of innovative health education and culturally appropriate interventions into the program; provision of adequate maternity leaves to women in the PMTCT program as well as full integration of the PMTCT program into the District Health System (DHS) as part of the “horizontal” delivered package.
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