Assessing Retention of Women Enrolled in Prevention of Mother-To-Child Transmission of HIV Programme at the Ho Municipal Hospital
Date
2017-07
Authors
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Journal ISSN
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Publisher
University of Ghana
Abstract
Background: Prevention of mother-to-child transmission of HIV (PMTCT) is delivered in stages
(or cascades) and high level of retention at each cascade step by mother and later by mother-infant
pairs is required to eliminate maternal transmission of HIV which occurs through pregnancy, childbirth and breastfeeding. Reasons for low rates of retention in Ghana are not well understood
though HIV sentinel sites situated across the country serve as good resource for collecting data for
generating such knowledge. The aims of this study were to determine retention rates at each stage
of tile PMTCT cascade and explore patient and provider- level factors affecting retention at the Ho
Municipal Hospital.
Methods: Retrospective data was collected from folders and electronic records of 69 women who
were enrolled into PMTCT from January 20 14 to December 2015. Data was entered into a PMTCT
Cascade Analysis Tool and retention rates at different stages of the cascade was calculated. In-depth
interviews were conducted for twelve mothers and seven carefully selected frontline
PMTCT care providers. Patient-level and provider-level factors were manually extracted and
Coded from transcribed recorded conversation.
Findings/Results: Twelve-month postpartum retention was 66.7%. The highest drop-off along the
cascade was found at the ' first at-risk child visit' for which 20 out of 52 babies were not brought
for early infant diagnosis (EID). Provider-level factors identified as determinants for retention
included counselling support, assurance of anonymity, clinic location and supportive and
understanding team. Patient- level factors that emerged were desired quality life, social support and
acceptance, stigma, and partner influences.
Conclusion: Retention in PMTCT at the Ho Municipal Hospital was lower compared to reviewed
literature from other resource constraint locations. Good counselling support, assurance or
confidentiality. desired treatment outcome and privacy of clinic location are some of the reasons
shown to affect retention at this site.
Description
MSc. Public Health
Keywords
HIV, Mother-to-child transmission, Ho Municipal Hospital, Ghana, Prevention of HIV