Evaluation of utilisation of the Prevention of Mother-to-Child Transmission of HIV Programme in Central province, Kenya

Author: Ngugi, Catherine Njeri

Date: 2013

Publisher: ResearchSpace@Auckland

Type: Thesis

Link to this item using this URL: http://hdl.handle.net/2292/21215

The University of Auckland Library

Abstract

Background: The PMTCT HIV programme has been one of the most successful HIV preventive interventions towards HIV-free future generations. However, even though the programme is virtually effective in developed countries, many developing countries are reporting child HIV infections due to the MTCT. The programme has existed in Kenya for more than a decade, yet in 2011, 12,894children were HIV infected due to MTCT Objective: To evaluate the PMTCT programme, especially the HIV testing from the antenatal period to the postnatal period among expectant parents attending Nyeri Provincial General Hospital in Central Province, Kenya. Design: Retrospective analysis of the hospital registers. Methods: Three hospital registers were analysed for the period from July 2009 to September 2012. The registers were for antenatal, intrapartum and postnatal care respectively. Each register documented the utilisation of PMTCT services by the expectant parents. Descriptive and inferential statistics were produced to analyse data from the registers. Results: The PMTCT services utilisation was sub-optimal. Of the 504 expectant mothers who attended the antenatal clinic, 59.9% came once, 80.4% had their first visit in the third trimester (between weeks 28 and 40) and only 6.9% were accompanied by their partners. All the women were HIV tested in their first visit but only 12.1% were rescreened after three months, and only 3.8% had been tested prior to the current pregnancy (p=0.000). No expectant mother was tested for HIV intrapartum or postpartum. The children of the 504 mothers who were HIV tested were those whose parent/s were known to be HIV positive or who had presented to a child welfare clinic with recurring symptoms suggestive of a failing immune system. Conclusion: Public health programs need to strengthen the PMTCT and HIV prevention programmes to ensure that HIV testing preconception and in pregnancy is fully implemented and strengthened, alongside continued education of the public through community programmes and the media. To avert further horizontal and vertical transmission of HIV, there is a need to address urgently the identified missed opportunities in the PMTCT program. These programmatic challenges require health system redesign and strengthening, resource allocation, addressing research gaps and reassessing the current PMTCT policies.

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