HIV testing uptake among pregnant women attending private midwife clinics: challenges of scaling up universal HIV testing at the private sectors in Indonesia

Wulandari, Luh Putu Lila; Lubis, Dinar Saurmauli; Widarini, Putu; Widyanthini, Desak Nyoman; Wirawan, I Made Ady; Wirawan, Dewa Nyoman

doi:10.1002/hpm.2807

Cited by 11 publications

(20 citation statements)

References 17 publications

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“…It is a part of a larger PMTCT project, conducted between June and December 2010, aimed at advancing the role of private midwives in referring pregnant women for VCT. 6 During that project, 70 midwives were trained in PMTCT strategies and directions, and referral systems. It was noted that the training participants had made 619 referrals to VCT clinics in both regions; yet, only 312 women, or half of those being referred, had ever visited a VCT clinic.…”

Section: Methodsmentioning

confidence: 99%

“…The results of the project on VCT uptake have been published elsewhere. 6 The current explorative qualitative study employed two focus group discussions (FGDs) with 15 midwives and five in-depth interviews to explore midwives' perceived barriers and enabling factors in their efforts to refer pregnant women for HIV testing in Bali. Participants were recruited and purposively selected from the 70 private midwives who had participated in the larger PMTCT projects.…”

Section: Methodsmentioning

confidence: 99%

“…Participants were recruited and purposively selected from the 70 private midwives who had participated in the larger PMTCT projects. 6 Midwives had working experience more than five years and had referred at least five women to VCT clinics. All 15 midwives were trained on PMTCT principles and how to refer patients for VCT.…”

Section: Methodsmentioning

confidence: 99%

“…For example, a report from a lo-cally based non-government organization (NGO) in Bali, the Kerti Praja Foundation, reported a prevalence of 0.9%, double that reported by the serosurveillance of 321 pregnant women who underwent HIV testing. 6 Human Immunodeficiency Virus testing during antenatal care (ANC) is the key to eliminate MTCT. Early detection of HIV in pregnant women and antiretroviral medicines can reduce the risk of vertical transmission to less than 5%.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Private Midwives’ Perceptions on Barriers and Enabling Factors to Voluntary Counselling and HIV Test (VCT) in Bali, Indonesia

Lubis

Wulandari²,

Suariyani³

et al. 2019

Kesmas: National Public Health Journal

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In Indonesia, more than half of pregnant women seek antenatal care (ANC) at private midwifery clinics. The midwives play an important role in advocating for voluntary counseling and testing (VCT) uptake among pregnant women during ANC. This study examined midwives’ perception of barriers and enabling factors with regards to refer pregnant women for HIV testing. The study was conducted in Denpasar City and Badung District, two localities in Bali with high HIV prevalence. Two focus groups discussions with 15 private midwives and five in-depth interviews were conducted. Data were transcribed verbatim and thematic analysis methods were used to examine patterns emerging from the data. Results showed that private midwives face personal barriers in the form of stigma as well as institutional barriers such as VCT operational hours that limit how and when they refer women for VCT. Barriers are strengthened by lack of support or reward from the health office. However, opportunities for integrated and comprehensive support systems within the health system and supportive social environment which would make it easy and rewarding for midwives to refer women to VCT clinics were seen as enabling factors. Increasing uptake of VCT is a necessity for eliminating mother to child HIV transmission.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Private Midwives’ Perceptions on Barriers and Enabling Factors to Voluntary Counselling and HIV Test (VCT) in Bali, Indonesia

Lubis

Wulandari²,

Suariyani³

et al. 2019

Kesmas: National Public Health Journal

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“…The 2014 health reforms in Indonesia advocated for increased universal health coverage (UHC) for all Indonesians, including the provision of integrated human immunodeficiency virus (HIV) programmes, with HIV testing to be available at community health centres and hospitals for pregnant women and women of childbearing age. [1][2][3] Annually in Indonesia, 40% of new HIV cases occur in women of childbearing age. 4 These women fall outside prescribed high-risk groups [i.e.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of and barriers to HIV testing of women in Indonesia

Najmah

Andajani

Davies

2020

Sexual and Reproductive Health Matters

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Indonesia’s 2014 health reforms advocated for universal health coverage for all Indonesians. The reforms made provision for integrated human immunodeficiency virus (HIV) programmes, with testing available at community health centres and hospitals for pregnant women and women of childbearing age. The question remains, though, as to whether testing has been effective. This article focuses on barriers women face accessing HIV testing and presents findings from the experiences of 18 HIV-positive women. To triangulate findings, interviews were conducted with 26 health workers, 9 non-governmental organisation workers and 12 HIV stakeholders. The article examines barriers to pregnant women’s access to HIV tests, showing that barriers relate to women not having reproductive health rights. It highlights reproductive rights noted in the Respectful Maternity Care Charter, and violations to them relevant to HIV testing in pregnancy. Five reported rights violations include: women being unable to access information; being unable to make informed decisions; having no right to confidentiality and privacy; experiencing ongoing discrimination; and having no right to timely HIV testing. The failure of Indonesia to protect these rights contributes to women being denied HIV testing. Findings show the need for increased HIV testing services for pregnant women and assert that health personnel and programme policy-makers need to be held accountable for the protection and fulfilment of women’s rights in respect of HIV testing. The findings show that policy makers must make changes to ensure health services improve, health professionals must be better trained, and women’s socio-cultural and political contexts must be considered.

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Factors affecting antenatal screening for HIV in Nepal: results from Nepal Demographic and Health Surveys 2016 and 2022

Sabin,

Saville,

Dixit Devkota

et al. 2023

BMJ Open

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ObjectivesAntenatal screening for HIV remains low in Nepal. Identifying factors associated with the uptake of antenatal screening is essential to increase uptake and prevent mother-to-child transmission (MTCT). This study investigated the effects of individual-level and district-level characteristics on the utilisation of antenatal screening for HIV in Nepal and how these effects changed between 2016 and 2022.DesignWe used publicly available cross-sectional data from 2016 to 2022 Nepal Demographic and Health Surveys.SettingStratified, multistage, random sampling was used to collect nationally representative data.Participants1978 and 2007 women aged 15–49 years who gave birth in the 2 years preceding the surveys.Primary and secondary outcome measuresWe used multilevel models to estimate associations between antenatal screening and potential factors influencing it in 2016 and 2022. We used districts as a random effect and looked at the intraclass correlation coefficients to disentangle the geographical effects. To distinguish barriers to HIV screening from barriers to accessing antenatal care (ANC) services, we performed similar analyses with whether the woman attended at least one ANC visit as the dependent variable.ResultsFactors associated with antenatal screening have not changed significantly between 2016 and 2022. Higher uptake of HIV screening was found among women with higher education, the pregnancy being desired later and women who had four or more ANC visits. Being from a poorer family and having low knowledge of MTCT and the medicines to prevent transmission were associated with lower uptake. From the supply side, no factors had a significant effect on antenatal screening. Factors associated with antenatal screening and those associated with any ANC were different. Our results also showed a partial importance of geographical factors on screening uptake.ConclusionsOur results supported that antenatal screening could be improved by enhancing access to information and improving the availability of free screening.

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HIV testing uptake among pregnant women attending private midwife clinics: challenges of scaling up universal HIV testing at the private sectors in Indonesia

Cited by 11 publications

References 17 publications

Private Midwives’ Perceptions on Barriers and Enabling Factors to Voluntary Counselling and HIV Test (VCT) in Bali, Indonesia

Private Midwives’ Perceptions on Barriers and Enabling Factors to Voluntary Counselling and HIV Test (VCT) in Bali, Indonesia

Perceptions of and barriers to HIV testing of women in Indonesia

Factors affecting antenatal screening for HIV in Nepal: results from Nepal Demographic and Health Surveys 2016 and 2022

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