Factors that influence male partner involvement in (PMTCT) prevention of mother to child transmission of HIV in Murang’a district hospital: health care providers factors.

Abstract

The purpose of the study was to establish the factors that influence male partners’ involvement in Prevention of Mother to Child Transmission (PMTCT) of HIV and focused on health care provider factors in the context of Murang’a District hospital, Kenya. The study adopted a census method and aimed at contacting all 110 PMTCT clients as respondents and all 10 Health Care Workers (HCWs) as key informants. To complement each other, structured interviews, in-depth interview guides, secondary data collection guide and observation checklist were used as key data collection instruments. The raw data from the field was analyzed using Statistical Package for Social Sciences and MS excel. Descriptive statistics were used in interpretation of findings and mainly used frequencies and percentages to present the data. The study revealed that the majority of the respondents (78%) had education up to secondary school and beyond and that majority (44%) was married. The study established that out of the 108 respondents, 53.7 percent of them had informed their male partners about their PMTCT clinic appointment while 46. 3 percent indicated that they had not. Three quarters of the respondents (75%) stated that they would like to involve their partners in the PMTCT program and 25 percent indicated that they would not. Despite the majority of respondents (75%) indicating that they would like to involve their partners in the PMTCT program, only 53 percent had invited their male partners to accompany them to the PMTCT clinic and 47 percent had not. On the other hand, the study found out that 19 percent of the respondents had ever been accompanied to the PMTCT clinic by their male partners while the majority, (81%) had never. The study findings indicated that 1.9 percent of the respondents had ever attended PMTCT support group with their male partners while the greater percentage (98.1%) of the respondents stated that they had never. The study results further revealed that 16 percent of the respondents and their male partners had ever been counseled on PMTCT and the majority (84%) had never. The study established that more than three quarters of the respondents (78.7%) indicated that the HCWs had discussed the importance of male involvement with them while 21.3 percent stated that HCWs had not discussed. The study findings further revealed that majority of the respondents (97.2 %) had been asked by the HCWs to invite their male partners while 2.8 percent indicated that they had not been asked. As regards the provision of Information, Education and Communication (IEC) materials to the respondents by the HCW, 1 percent indicated that they had been provided and the majority, (99 %) stated that they had not. A small percentage (15%) of the respondents confirmed that HCWs paid attention and invited male partners to the PMTCT clinic while the larger percentage, (85%) said the HCWs did not. Results from cross tabulation of data revealed that economic activities of the respondents were only associated with the partner being aware of the respondents visit to the hospital and that economic activity was not associated with all the other aspects related to uptake of male involvement services in PMTCT clinic. Further, cross tabulation showed that marital status of the respondents was associated with several aspects related to participation in male involvement services in PMTCT clinic. Marital status was associated with partner being aware of clinic visit, respondent having ever invited the partner to the clinic and respondent ever having had a joint counseling session with the partner. Marital status factor was not associated with any other aspects of male involvement. Cross tabulation results revealed that age and level of education were not significant factors associated with any of the aspects of male involvement. In conclusion, major impediments to male involvement in PMTCT program were found to be that staff were not trained in PMTCT and male involvement; inadequate space for counseling; inadequate community mobilization and sensitization; lack of integration of health services and lack of proper male involvement guidelines in PMTCT program. The findings indicate that the level of male involvement is still minimal. The study therefore recommends that the health facility should hire more HCWs, train them on male involvement in PMTCT program and provide them with guidelines and standard operating procedures for the PMTCT program. The facility should expand counseling rooms, integrate health services and conduct community outreach activities