Browsing by Author "Lusaka, Mildred Mwewa"

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    Experiences of mothers administering HIV post-exposure prophylaxis to their infants in Lusaka, Zambia
    (Stellenbosch : Stellenbosch University, 2018-03) Lusaka, Mildred Mwewa; Crowley, Talitha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background Effective Prevention of Mother-to-Child-Transmission (PMTCT) programs require women and their infants to have access to and to participate in a cascade of interventions including antenatal, postnatal and child health services. This includes HIV testing during pregnancy and the use of antiretroviral treatment (ART) with good adherence. HIV-positive mothers should be guided to practice safe childbirth, provide appropriate infant feeding, bring their infants for HIV testing and to administer antiretroviral (ARV) Post-Exposure Prophylaxis (PEP) to their infant’s post-delivery, for the prescribed period. Currently contextual information relating to the experiences of mothers administering ARV drugs for prophylactic purposes in Lusaka, Zambia is limited. The research endeavoured to explore the experiences of mothers administering PEP to their infants in Lusaka, Zambia. Methods The study followed a qualitative methodology with a descriptive design to explore the mothers’ experiences of administering PEP to their infants. Fifteen semi-structured individual interviews were conducted using open-ended questions. The targeted population were mothers that were required to administer PEP to their infants. Data analysis was guided by Creswell’s six-step model of data analysis. The study was approved by the Health Research Ethics Committee (HREC) of the University of Stellenbosch Faculty of Medicine and Health Sciences, the University of Zambia Bio-Medical Research Ethics Committee (UNZABREC) and the Ministry of Health (MOH). Trustworthiness was ensured by following the four principles of credibility, transferability, dependability and confirmability. Findings The participants experienced emotional stress and demonstrated a lack of knowledge and understanding about the need for PEP. Challenges experienced by them included difficulties with PEP administration, attending healthcare appointments, cultural and religious influences, lack of partner involvement and stigma and discrimination. Other social challenges that affected the administration of PEP were lack of disclosure to partners for fear of stigma and discrimination with possible abandonment. However, some participants’ own belief in the efficacy of PEP made them continue attending postnatal care. Conclusion Most women accepted and understood that PEP reduced the possibility of HIV infection of their infants and accepted it as part of the PMTCT programme. However, several challenges to PEP administration were identified. Administering PEP is emotionally challenging due to fear and apprehension that the baby may become HIV-positive. Although some women are supported in the administration of PEP, lack of knowledge, cultural and religious practices and stigma deter women from continuing to administer PEP. Long waiting times for laboratory results, insufficient supplies of Nevirapine and ineffective counselling were identified as health system barriers to continued PEP administration. Support for women to administer PEP can be enhanced through cultural empowerment, involving partners and family members and the training of healthcare workers.