Browsing by Author "Ankrah, A.K."
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Item Factors influencing the delivery and uptake of early infant diagnosis of HIV services in Greater Accra, Ghana: A qualitative study(PLOS ONE, 2021) Ankrah, A.K.; Dako-Gyeke, P.Background Early Infant Diagnosis (EID) of HIV and timely initiation of Antiretroviral Therapy (ART) can significantly reduce morbidity and mortality of HIV infected infants. Despite the benefits of early infant testing, the coverage of EID of HIV services is still low in Sub-Saharan Africa, including Ghana. Objectives To ascertain the factors that facilitate or hinder the delivery and uptake of EID of HIV services. The study is a cross-sectional exploratory qualitative research conducted in two health facili ties in the Greater Accra Region of Ghana. Respondents (n = 50) comprising health workers (n = 20) and HIV positive mothers (n = 30) were purposively sampled and engaged in in depth interviews. The Nvivo 11 software and the Braun and Clarke’s stages of thematic analysis were used in coding data and data analysis respectively. The study found that health system factors such as inadequate Staff with sample collection skills, unavailability of vehicles to convey samples to the reference laboratory for analysis, the long turnaround time for receipt of Polymerase Chain Reaction (PCR) results, inadequate and frequent breakdown of PCR machine hindered EID service delivery. On the other hand, adequate knowledge of health workers on EID, availability of Dried Blood Spot (DBS) cards and the adoption of task shifting strategies facilitated EID service delivery. Factors such as the denial of HIV status, non-completion of the EID process due to frustrations encountered whiles accessing service and delay in receipt of PCR results served as barriers to mother’s utilisation of EID services for their exposed infants. The study also identified that adequate knowledge of EID, perceived importance of EID, financial stability as well as financial support from others and the positive attitudes of health workers facilitated HIV positive mother’s uptake of EID services for their exposed infants. The factors attributing to the low coverage of EID of HIV services must be promptly addressed to improve service delivery and uptake.Item Factors Influencing Use of Early Infant Diagnosis of Hiv Services within the Accra Metropolitan and Ledzokuku Krowor Municipal Area(University Of Ghana, 2018-07) Ankrah, A.K.Introduction: It is estimated that over 90% of HIV infections in children is acquired through mother to child transmission (MTCT). Transmission can however be prevented if infected mothers have access to antiretroviral therapy (ART) during pregnancy, delivery and breast feeding. According to WHO, the absence of ART can increase MTCT rates by 15% to 45% however, transmission rates can reduce to below 5% with the availability of ART. It is therefore imperative that all infants born to HIV positive mothers are promptly diagnosed and initiated on ART if found to be reactive. Providing HIV infected infants with timely HIV interventions and treatment could increase their survival rate by 75%. Irrespective of the benefits obtained from early infant testing, the use of Early Infant Diagnosis (EID) of HIV services is unacceptably low in Sub-Saharan Africa, including Ghana. It is critical that the factors attributing to low coverage of EID services are immediately identified and addressed. Objective: The purpose of the study was to ascertain the knowledge of health workers and HIV positive mothers on EID services. It also sought to identify the health system factors that influenced delivery of EID services, the barriers to the use of EID services among HIV positive mothers and also their perceptions on the use of the service. Methods: The study was an exploratory qualitative research conducted at the Greater Accra Regional Hospital and the LEKMA Hospital. A criterion purposive sampling technique was utilised in selecting study participants. Fifty respondents comprising 20 health workers and 30 HIV positive mothers were engaged in in-depth interviews. Braun and Clarke’s stages of thematic analysis were employed in analysing data. Results: Both health workers and HIV positive mothers were adequately knowledgeable of EID of HIV services. Health system factors such as inadequate staff, transportation challenges, long turnaround time for the return of PCR results, inadequate and frequent breakdown of PCR machine were identified as inhibitors to EID service delivery. Availability of DBS cards, adoption of task shifting strategies and positive attitudes of health workers served as facilitators. Maternal factors such as denial of HIV status, lost to follow up in the EID process, dependency on significant others and consequences after disclosure of HIV status were factors that served as barriers to mother’s utilization of EID services for their exposed infants. Conclusion: The study concludes that maternal and health system factors influence the utilization of EID services. It is important that the identified hindering factors are urgently addressed to improve service use.