Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya

Abstract

BackgroundThe prevention of mother-to-child transmission (PMTCT) is considered one of the most successful HIV prevention strategies in detecting and reducing HIV acquisition in utero or at birth. It is anticipated that with the increasing growth of digital technologies mobile phones can be utilized to enhance PMTCT services by improving provider-client interactions, expanding access to counseling services, and assisting in counteracting social and structural barriers to uptake of PMTCT services. Understanding the subjective experiences of women accessing PMTCT services in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of HIV-positive pregnant women attending maternal and neonatal clinic services in Kisumu, Kenya.MethodsData are reported from in-depth interviews with women, following a longitudinal study investigating the impact of a structured, counselor-delivered, mobile phone counseling intervention to promote retention in care and adherence to ARV prophylaxis/treatment, for HIV-positive pregnant women. Thematic content analysis was conducted.ResultsDiscussions indicated that mobile-phone counseling provided useful health-related information, enhanced agency, and assisted mothers access critical PMTCT services across the cascade of care. Similarly, mobile-phone counseling offered personalized one-to-one contact with trained health providers including facilitating discussion of personal issues that likely affect access to services. Findings also identified barriers to the uptake of services, including a lack of partner support, poor health, poverty, facility-related factors, and provider attitudes.DiscussionOverall, findings show that mobile-phone counseling is feasible, acceptable, and can enhance access to PMTCT services by overcoming some of the individual and facility-level barriers. Although mobile-phone counseling has not been routinized in most health facilities, future work is needed to assess whether mobile-phone counseling can be scaled-up to aid in the effective use of HIV and PMTCT services, as well as improving other related outcomes for mother and child dyad.

Approaches for prevention of mother-to-child transmission of HIV services during coronavirus disease 2019

“…The authors further argue that such a scenario is concerning as it has negative effects on treatment outcomes, however, this was done to curb the pandemic. According to Okal et al ( 2022 ), counselling is a critical component of client management in HIV care and treatment services and should be patient-centred and meet the unique needs of each patient. Evidence has demonstrated that use of virtual counselling was an important initiative that was necessary to enhance PMTCT outcomes during COVID-19 pandemic (Okal et al 2022 ).…”

“…According to Okal et al ( 2022 ), counselling is a critical component of client management in HIV care and treatment services and should be patient-centred and meet the unique needs of each patient. Evidence has demonstrated that use of virtual counselling was an important initiative that was necessary to enhance PMTCT outcomes during COVID-19 pandemic (Okal et al 2022 ). The use of telehealth strategies observed in this study has also proved to be effective and key to enhance the continuum of care.…”

“…Evidence has shown that during the COVID-19 pandemic communication between providers and recipients of care was mainly through health education and there were minimal counselling sessions through physical means; hence, use of virtual counselling became a key important innovation (Bisnauth et al 2020 ; Okal et al 2022 ). According to Okal et al ( 2022 ) and Knettel et al ( 2018 ), telehealth strategies became paramount in facilitating treatment continuity through sending appointment reminders and providing adherence support.…”

Enhancing Performance of HIV/AIDS Projects through Digital Health Interventions for Client Appointments in Kisumu County, Kenya

“…Most of the studies and projects demonstrate positive impacts resulting from the use of DHIs for both infectious and noncommunicable chronic diseases (Hong & Guo, 2018;Lester, 2013;Mohammed et al, 2016). Further, DHIs are capable of enhancing systems in a much more effective and efficient manner while creating accountability compared to manual processes (Mohammed et al, 2016;Okal et al, 2016;Vojnov et al, 2017).…”

Uptake of prevention of mother-to-child transmission of human immunodeficiency virus interventions among infected mothers attending health facilities in Mombasa County, Kenya

“…In Kenya, the Uptake could be better nationally at 8.5% and worse for Mombasa at 9.1%. 6 Kenya is one of the 22 countries that account for 90% of all pregnant mothers with HIV worldwide. 7 In Kenya, initiatives to reduce mother-to-child transmission (PMTCT) are seamlessly incorporated into Maternal and Child Health (MCH) services within healthcare institutions.…”