Reasons for Default from Prevention of Mother to Child Transmissions (PMTCT) of HIV Program in Addis Ababa
Creators: name: Bekele, Yonas
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2007

description: Back Ground: As of February 2004 Prevention of Mother to child transmission of HIV program was started as "hareg" project at five health facilities in Addis Ababa which later expanded to 33 sites. Since its starts, yearly regional health bureau report showed that the region didn`t achieved the national Prevention of Mother to child transmission of HIV program target in relation to counseling and test acceptance. More ever less than half of HIV positive mothers and their infant have taken full course of Nevirapin while the other half default from Prevention of Mother to child transmission of HIV program and they didn`t take Nevirapin. Objective: the main objective of the study is to identify reasons of HIV positive women for defaulting from PMTCT program and not taking ARV prophylaxis in Addis Ababa after they receive their post test HIV result. Methods: Prevention of Mother to child transmission of HIV program uptake analysis was done among ANC attendants for Prevention of Mother to child transmission of HIV –Voluntary counseling and testing uptake and on the uptake for Nevirapin for all Prevention of Mother to child transmission of HIV mothers and their newborns during two years of Prevention of Mother to child transmission of HIV program implementation at "Hareg" pilot sites by reviewing national registration, recording and reporting formats. Qualitative study through in depth interview with HIV positive mothers who lost from PMTCT program and focus group discussion with health professional working at PMTCT clinic and mother to mother support group were conducted to investigate the women`s reasons for not accepting ARV prophylaxis in PMTCT program in Addis Ababa at "Hareg" PMTCT pilot sites. Collected data were translated, transcribed, prepared in Microsoft word document which is changed to plain text. The document imported to Open code soft ware, and coding, listing of frequencies, and data reduction were done. The data then summarized. Interpretations of data, drawing of conclusion were performed. Result:- Total of 95378 new antenatal care attendants were registered during this two-year period, of whom 44095 (46%) enrolled for VCT at the PMTCT program and 28635 (65 %) tested for HIV. Three thousands four hundreds and eighteen (3418) (11.9%)mothers tested HIV positive and were therefore enrolled in the PMTCT program. However, only 1913 (56%) HIV positive pregnant mothers received the Nevirapine during delivery. Moreover: only 1965(57%) newborns received Nevirapine within 72 hours after birth showing close to half of mother`s lost to follow up and didn`t receive Nevirapin. Quality of health care during PMTCT counseling, follow up, and delivery, stigma and discrimination were identified as the main reasons for loose from PMTCT follow up and not took ARV prophylaxis during delivery. Additional reasons mentioned includes personal factors associated with the clients including religion related factors, distance from facilities, changing of place and disclosure. Conclusion and recommendation Strengthening monitoring and Evaluation of PMTCT programs, mothers to mothers support group, community mobilization, quality assurance program in PMTCT, nutritional support and involvement of families in PMTCT program would have paramount benefit in increasing ARV prophylaxis uptake. Key words: PMTCT, ARV prophylaxis, Mother to mother , Nevirapin