Assessment of Factors Influencing the Uptake of Elimination of Mother to Child Transmission Services Among Pregnant and Breastfeeding Mothers in Shangombo District, Zambia
Authors:   Faculty of Nursing and Midwifery, Lusaka Apex Medical University, Lusaka, Zambia, Saul Simbeye Tinkler , Phinias Miyoba ,   Department of Public Health, Texila American University, Georgetown, Guyana, Chisanga Arthur ,   Faculty of Nursing and Midwifery, Lusaka Apex Medical University, Lusaka, Zambia, Mwansa Pamela ,   Department of Public Health, Cavendish University, Lusaka, Zambia, Mandona Evason ,   Department of Public Health, Chibombo College of Health Sciences, Chibombo, Zambia, Dawria Ibrahim Adam ,   Department of Public Health, King Khalid University, Asir-Abba, Saudi Arabia, Katunga Monica ,   School of Nursing and Midwifery Sciences, Eden University, Lusaka, Zambia, Nyahodah Isabel , Phiri Bernadette , Kachinda Wezi ,   Faculty of Medicine, Lusaka Apex Medical University, Lusaka, Zambia, Matipa Mulenga Marian ,   Department of Emergency Preparedness and Response, Zambia National Public Health Institute, Lusaka, Zambia
Published: June 2024

Introduction: Elimination of Mother to Child Transmission (EMTCT) involves stopping the passing of HIV, syphilis, and hepatitis B from a mother to her child during pregnancy, labour, delivery, and breastfeeding. The role of EMTCT programs is to guarantee that MTCT for HIV, syphilis, and HBV is managed and incidence is lowered to such a low level that these diseases no longer pose a public health risk. The effective prevention of mother to child transmission of HIV is dependent on diagnosing maternal infection early and beginning and maintaining lifetime treatment for all women and girls of reproductive age with HIV, offer care programs and preventive care for male partners. Objectives: To identify the knowledge level of pregnant and breastfeeding mothers regarding EMTCT services in Shangombo District, to examine the availability and accessibility of EMTCT services within health facilities in Shangombo District, to assess the role of healthcare provider attitudes and communication in influencing the uptake of EMTCT services among pregnant and breastfeeding mothers in Shangombo District. Methods: A descriptive cross-sectional and retrospective study designs were employed to evaluate all EMTCT services offered to all pregnant and breastfeeding mothers in Shangombo district. A simple random sampling method was employed to select participants for this study. The total sample size for this study was 202. Participants who voluntarily consented were provided with a questionnaire to complete. Structured questionnaire was utilized to collect data which was analyzed by Statistical Package for Social Sciences (SPSS) version 22.0 and was presented by tables. Multivariate logistic regression analysis was employed to explore the relationships between socio-demographic characteristics and elimination of mother to child transmission of HIV parameters. Results: The study disclosed that, most of the respondents had adequate level of knowledge on EMTCT services. This is because the vast majority (93.6%) of respondents have heard about EMTCT services. Many of the respondents, (84.6%) are aware that EMTCT services help to prevent the transmission of HIV from mother to child during pregnancy, labour, delivery and breastfeeding in Shangombo district. The study has also disclosed that, nearly all respondents (93.1%) know where to access EMTCT services in Shangombo district. The study also disclosed that, most of the respondents (93.1%) agreed that, they received information or counseling about EMTCT services during their pregnancy from health care providers. A substantial proportion of respondents (84.2%) affirmed that, they were aware that, exclusive breastfeeding help to prevent HIV transmission from HIV positive mothers to the babies which highlights a positive trend in knowledge dissemination and health education efforts. The study also disclosed that, a high proportion of pregnant and breastfeeding mothers (98.0%) visited health facilities during their pregnancy/breastfeeding period in Shangombo district. The study has also revealed that, a substantial portion of respondents (75.7%) had challenges in accessing EMTCT services due to their availability and accessibility issues. A good proportion of study participants (91.6%) agreed that, they were provided with information about EMTCT services during their visit to the health facility. While a considerable number of respondents (67.3%) found it easy to access EMTCT services within health facilities, a significant minority (32.7%) encountered difficulties. It was also found that, a good proportion of study participants (88.6%) were aware about the benefits of timely utilization of EMTCT services. The study has also disclosed that, most of the respondents (87.6%) agreed that, they discussed the steps involved in how to utilize and access EMTCT services with healthcare providers during their visit to the health facility. The study has also revealed that, many respondent (94.1%) agreed that, healthcare providers play a critical role in shaping the perceptions of pregnant and breastfeeding mothers regarding EMTCT services in Shangombo District. A significant majority (90.8%) of respondents recognized effective communication by healthcare providers as a crucial factor in encouraging pregnant and breastfeeding mothers to utilize EMTCT services. The data also suggest that improving healthcare provider attitudes has the potential to increase the utilization of EMTCT services among pregnant and breastfeeding mothers, with 93.1% of respondents agreeing to this statement. The data also indicate that healthcare provider attitudes and communication are perceived as vital in influencing the uptake of EMTCT services among pregnant and breastfeeding mothers, with 90.3% of respondents agreeing to this statement. The findings have also shown that, 90.6% of respondents affirmed that positive interactions with healthcare providers encourage pregnant and breastfeeding mothers to engage with EMTCT services. Conclusion: In conclusion, the findings reveal a high level of awareness among pregnant and breastfeeding mothers regarding EMTCT services, indicating effective dissemination of health information through various channels such as health education, health communication, Social mobilization and community engagement. While respondents demonstrate adequate level of knowledge about EMTCT services and their benefits, challenges persist in accessing these services due to availability issues. Efforts should thus concentrate on improving availability, enhancing communication and counseling skills among healthcare providers, addressing accessibility barriers, and strengthening provider training in order to ensure optimal care and support for EMTCT services utilization among pregnant and breastfeeding mothers. The author recommends that, there is a need to conduct a study on the impact of healthcare provider attitudes and communication on the utilization of EMTCT services in Shangombo District of Zambia.