Knowledge and practices of women regarding prevention of mother-to-child transmission of HIV (PMTCT) in rural south-west Uganda

Abstract

Knowledge and practices of women regarding prevention of mother-to-child transmission of HIV (PMTCT) in rural southwest Uganda Worldwide, about 3.4 million children aged under 15 years are HIV-infected, with 90% living in Sub-Saharan Africa; 1 150 000 of these children are in Uganda. Ninety-five percent of pediatric HIV in Sub-Saharan Africa results from mother-to-child transmission (MTCT) during pregnancy, labor, or with breastfeeding. Prevention measures (PMTCT) can reduce the risk of MTCT, 2 but only if women have this knowledge. [3][4][5][6] Currently, in rural south-west Uganda, information on MTCT and PMTCT is provided to women by local health workers including volunteer village health teams. 7 This study explored the knowledge and practices of women in rural south-west Uganda regarding MTCT and PMTCT to determine if women have this needed knowledge.We conducted an exploratory descriptive study among women of child-bearing age (15-49 years) from Mwizi, a rural sub-county in Mbarara district in south-west Uganda, in July and August 2011. A semi-structured oral questionnaire was administered to 100 women randomly sampled from the five sub-county parishes; 10 women per parish.Of the 100 women approached, all participated; 88% were aged between 15 and 25 years, 88% had a primary education, 84% were peasant farmers, 88% were married, and 91% had been pregnant or were pregnant at the time of the study. Ninety-one percent knew that MTCT occurs; 72% were aware of PMTCT. Only 7% had adequate knowledge about MTCT and the needed prevention steps. While 82% knew MTCT can occur during labor and delivery, only 54% knew breastfeeding was a risk and only 23% knew HIV could be transmitted during pregnancy. Sixty-eight percent knew that delivery at a health facility could reduce the risk because additional preventative measures would be taken. Seventy percent recalled hearing messages about MTCT and PMTCT from a health worker, their major source of PMTCT information. Several women had practiced PMTCT interventions themselves or had advised their friends.In conclusion, most women of child-bearing age in Mwizi sub-county of Uganda lacked adequate knowledge to prevent MTCT despite high awareness of MTCT and the need for PMTCT. For PMTCT knowledge to trickle down to rural women, messaging from village health workers, the major source of information, needs to be reinforced. More training on techniques to reinforce PMTCT messages is needed. Other forms of messaging, i.e., radio and cell phone messages, village meeting discussions, and social gatherings might reinforce prevention awareness. 8,9

Knowledge, attitudes, and practices regarding exclusive breastfeeding among HIV‐positive mothers in Uganda: A qualitative study

“…All FGDs were based on a semi‐structured question guide, printed in both English and Luganda (see Appendix S1). It consists of 24 predetermined questions which were based on pretested questions used in similar sub‐Saharan African studies and piloted in this study . The FGDs were recorded with a dictaphone, and manual notes were also taken by the principal researcher.…”

MicroResearch: Finding sustainable local health solutions in East Africa through small local research studies

“…A study on glutamine supplementation for persistent diarrhea showed that this was ineffective in the East African setting [ 11 ] and should not be promoted as a local intervention. A study of women 15–45 years old in rural Uganda revealed gaps in knowledge about prevention of mother to child transmission of HIV and highlighted the need for different education strategies [ 12 ]. Following the publication of the extended abstract, the questionnaire was requested by an American team for adaptation for use in another African country.…”

Awareness and attitude of HIV-positive lactating mothers towards breast feeding at Kabwohe health center IV, Sheema district.

“…About 85% of the Ugandan population is rural based with limited access to information and health services [26]. The previous study done in Mwizi, a rural sub-county in the Mbarara district in southwest Uganda has shown a lack and mixed levels of knowledge regarding MTCT and EMTCT among women with only 54% knowing about the risk of HIV infection with breastfeeding [23]. No recent studies have been done in the Sheema district, particularly in a rural area of Kabwohe where reside number of HIVpositive lactating mothers are to find out their level of knowledge and attitude towards breastfeeding their babies.…”

“…Total 16 100% or more respectively. These age groups are still in reproductive age therefore, need to be empowered with knowledge regarding HIV infection, the risks of transmission to her baby, and the services available to reduce the risk [23]. Nearly 43% were married, followed by those cohabiting with 34%, single was 16%while the least 7% were others (who said they separated or .…”

“…The WHO [22], recommends lifelong HAART for HIVinfected women in need of treatment for their own health, which is also safe and effective in reducing MTCT or ARV prophylaxis to prevent MTCT during pregnancy, delivery and breastfeeding for HIV-infected women, not in need of treatment for themselves. A study done in southwestern Uganda showed that only 7% had adequate knowledge of how HIV was transmitted from mother to child and what steps are needed to prevent it while 82% knew that MTCT can occur during labor and delivery, only 54% knew about risk with breastfeeding, and only 23% knew that HIV could be transmitted to the fetus during pregnancy [23]. Currently, in rural Kabwohe information on HIV-positive lactating mothers breastfeeding is provided to women by local health workers that include volunteer village health teams with limited formal health training.…”