| dc.description.abstract | The severity of the problem of Mother-to-Child Transmission (MTCT) of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV / AIDS) in Sub-Saharan Africa is due to high rates of HIV / AIDS infection in women of reproductive age, the large total population of women of reproductive age, high birth rates and the lack of effective MTCT prevention interventions. Two-thirds of Human Immunodeficiency Virus (HIV) positive pregnant women in the developing world do not have access to services needed for effective prevention of MTCT of HIV, which leads to high rates of new HIV cases annually among infants. In Kenya, an estimate of 270 new pediatric HIV infections occurs each day through MTCT. In order to address this problem, the Kenyan Government has implemented several PMTCT programs throughout the country.
There has been a scarcity of studies especially in Kibera to evaluate the factors that determine effectiveness of these PMTCT services in ensuring quality prevention of MTCT. This study was thus prompted to establish the determinants of the effectiveness of PMTCT services being implemented by different programs in Kibera due to its high HIV prevalence rate of 15 percent double the national figure. The objectives of this study were to establish how male partner involvement influences the uptake of PMTCT services, how the perception of mothers towards PMTCT services influences the effectiveness, how the accessibility of these services to the mothers and the availability of follow-up mechanisms to trace defaulters affect the effectiveness of PMTCT services.
The findings of this study are important in making informative decision towards achieving the 2010-2015 strategic vision and Millennium Development Goals (MDGs) four and five. The study was a cross-sectional descriptive survey design in which 182 HIV positive mothers attending PMTCT services in PMTCT centers in Kibera and 27 health care workers in the same centers were contacted and taken through a semi structured questionnaire that was designed for each group. A systematic random sampling procedure was used to select the 182 mothers, while a purposive sampling procedure was used to select the health care workers by the fact that they had worked in that center for the last two years. A pilot study was conducted to ensure validity of the data and for reliability of the study instruments a test-retest technique was used.
Data was collected within a span of one week and was then entered in Statistical Package for Social Sciences (SPSS), cleaned and analyzed to obtain frequencies and percentages. Relationships among variables were computed through chi-square statistics. Approval of the study was obtained from University of Nairobi and PMTCT center administrators. Also an informed consent document was read to and explained to the participants for them to sign as acceptance to participate in the study. The study findings confirmed that male partner involvement is one of the major determinants to the effectiveness of PMTCT services with 62.4 percent of the married mothers confirming that they have had male directed violence due to their involvement in PMTCT programs.
Perception of the mothers was also found to be another determinant with 59.4 percent of the mothers confirming that they are not happy about various aspects of the program especially lack of confidentiality among the health care givers hence making them have a negative attitude. Poor accessibility of some PMTCT services is another determinant with 64.2 percent of the mothers defaulting from the programs. Poor follow-ups to track and trace the mothers is another determinant with 53.8 percent of the mothers who defaulted due to lack of follow-ups having HIV positive children and 24.5 percent of them, their children have died out of HIV infection. The study recommends that awareness targeting males should be emphasized and especially the less literate ones and also that PMTCT programs should adequately offer all the necessary services to the mothers and practice confidentiality. | en_US |
