High PMTCT Program Uptake and Coverage of Mothers, Their Partners, and Babies in Northern Uganda

Bannink, Femke; Lowicki-Zucca, Massimo; Ojom, Lawrence; Kabasomi, Sarah V.; Esiru, Godfrey; Homsy, Jaco

doi:10.1097/qai.0b013e318282d27f

Cited by 18 publications

(14 citation statements)

References 17 publications

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“…Among our representative sample of Salvadorian women of the lowest wealth quintile, less than 83% reported being screened for HIV during their last pregnancy. This rate is lower than the previously reported 97% for the year 2007 [12,19] and rates reported in other more or less developed countries, such as Canada and Uganda [20,23]. However, it is higher than the 76% of pregnant women served by the Indian Health Services who were screened for HIV in the United States in 2009 [24].…”

Section: Discussionmentioning

confidence: 64%

Disparities in HIV Screening among Pregnant Women – El Salvador, 2011

et al. 2013

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ObjectivesTo provide an accurate estimate of antenatal HIV screening and its determinants among pregnant women in El Salvador and help local authorities make informed decisions for targeted interventions around mother-to-child transmission (MTCT).MethodsA total sample of 4,730 women aged 15-49 years were interviewed from a random sample of 3,625 households. We collected data on antenatal care services, including HIV screening, during last pregnancy through a pre-established questionnaire. We used a backward elimination multivariate logistic regression model to examine the association between HIV screening and sociodemographic and health care-related factors. ResultsA total of 2,929 women were included in this analysis. About 98% of participants reported receiving antenatal care, but only 83% of these reported being screened for HIV. Screening was lower in geographic areas with higher HIV incidence and ranged from 69.1% among women who were not seen by a physician during antenatal care, to 93.7% among those who attended or completed college. Odds for screening varied also by age, employment status, household economic expenditure, possession of health care coverage, health care settings, and number of antenatal care visits. ConclusionsWe found disparities in HIV screening during antenatal care at the environmental, social, demographic, and structural levels despite a high uptake of antenatal care in El Salvador. Our findings should urge health authorities to tailor and enhance current strategies implemented to eliminate MTCT and reduce inequities and HIV morbidity among women in El Salvador.

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Section: Discussionmentioning

confidence: 64%

Disparities in HIV Screening among Pregnant Women – El Salvador, 2011

et al. 2013

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“…Three papers reported results of retrospective record reviews to evaluate programs to prevent mother to child transmission of HIV (PMTCT), two in northern Uganda and one in a refugee camp in Tanzania. One program found that higher proportions of HIV-positive pregnant women identified in ANC used anti-retroviral prophylaxis in northern Uganda compared with the national average [ 23 ]. The other two programs reported high numbers lost to follow-up before completing infant HIV testing at 18 months.…”

Section: Resultsmentioning

confidence: 99%

Evaluations of reproductive health programs in humanitarian settings: a systematic review

Casey

2015

Confl Health

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Provision of reproductive health (RH) services is a minimum standard of health care in humanitarian settings; however access to these services is often limited. This systematic review, one component of a global evaluation of RH in humanitarian settings, sought to explore the evidence regarding RH services provided in humanitarian settings and to determine if programs are being evaluated. In addition, the review explored which RH services receive more attention based on program evaluations and descriptive data. Peer-reviewed papers published between 2004 and 2013 were identified via the Ovid MEDLINE database, followed by a PubMed search. Papers on quantitative evaluations of RH programs, including experimental and non-experimental designs that reported outcome data, implemented in conflict and natural disaster settings, were included. Of 5,669 papers identified in the initial search, 36 papers describing 30 programs met inclusion criteria. Twenty-five papers described programs in sub-Saharan Africa, six in Asia, two in Haiti and three reported data from multiple countries. Some RH technical areas were better represented than others: seven papers reported on maternal and newborn health (including two that also covered family planning), six on family planning, three on sexual violence, 20 on HIV and other sexually transmitted infections and two on general RH topics. In comparison to the program evaluation papers identified, three times as many papers were found that reported RH descriptive or prevalence data in humanitarian settings. While data demonstrating the magnitude of the problem are crucial and were previously lacking, the need for RH services and for evaluations to measure their effectiveness is clear. Program evaluation and implementation science should be incorporated into more programs to determine the best ways to serve the RH needs of people affected by conflict or natural disaster. Standard program design should include rigorous program evaluation, and the results must be shared. The papers demonstrated both that RH programs can be implemented in these challenging settings, and that women and men will use RH services when they are of reasonable quality.

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“…The adult prevalence of HIV in Uganda is 7.3% overall; 8.3% for women compared to 6.1% among men [2]. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs enable women living with HIV (WLWH) to have children with minimal risks to their health and perinatal transmission [3]. However, being HIV positive and pregnant remains a challenging experience for women [4, 5]…”

Section: Introductionmentioning

confidence: 99%

Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda

Ashaba

Kaida

Burns

et al. 2017

BMC Pregnancy Childbirth

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BackgroundIn sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women’s perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women.MethodsWe conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February–August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis.ResultsTwenty women were interviewed with median age 33 (IQR: 28–35) years, CD4 cell count 677 cells/mm3 (IQR: 440–767), number of live births 4 (IQR: 2–6), and number of living children 3 (IQR: 2–4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner’s Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality.ConclusionsThe results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1321-9) contains supplementary material, which is available to authorized users.

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High PMTCT Program Uptake and Coverage of Mothers, Their Partners, and Babies in Northern Uganda

Abstract: Our results show how a comprehensive PMTCT program emphasizing social and community engagement alongside medical care and support can succeed in a remote setting with multiple challenges.

Cited by 18 publications

References 17 publications

Disparities in HIV Screening among Pregnant Women – El Salvador, 2011

Disparities in HIV Screening among Pregnant Women – El Salvador, 2011

Evaluations of reproductive health programs in humanitarian settings: a systematic review

Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda

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