BARRIERS TO PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES IN UGANDA
Identifieur interne : 000A98 ( Main/Exploration ); précédent : 000A97; suivant : 000A99BARRIERS TO PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES IN UGANDA
Auteurs : A. K. Mbonye [Ouganda] ; K. S. Hansen [Royaume-Uni] ; F. Wamono [Ouganda] ; P. Magnussen [Danemark]Source :
- Journal of Biosocial Science [ 0021-9320 ] ; 2010-03.
Abstract
Understanding care-seeking practices and barriers to prevention of mother-to-child transmission (PMTCT) of HIV is necessary in designing effective programmes to address the high disease burden due to HIV/AIDS in Uganda. This study explored perceptions, care-seeking practices and barriers to PMTCT among young and HIV-positive women. A household survey (10,706 women aged 14–49 years), twelve focus group discussions and 66 key informant interviews were carried out between January and April 2009 in Wakiso district, central Uganda. Results show that access to PMTCT services (family planning, HIV counselling and testing and delivery at health units) was poor. Decision making was an important factor in accessing PMTCT services. Socioeconomic factors (wealth quintile, age, education level) and institutional practices also influenced access to PMTCT. Overall, having had an HIV test was highest when both men and women made decisions together or when women were empowered to make their own decisions. This was significant across wealth quintiles (p=0.0001), age groups (p=0.0001) and education levels (p=0.0001). The least level of HIV testing was when men made decisions for their spouses; and this was the case with family planning and deliveries at health units. Other barriers to PMTCT were fear of women and male spouses to have an HIV test and the perception that HIV testing is compulsory in antenatal clinics. In conclusion, to increase access to PMTCT among women, especially the young, poor and least educated, there is a need to empower them to make decisions on health seeking, and also to empower men to support their spouses to make good decisions. Other barriers like fear of having an HIV test should be addressed through appropriate counselling of clients.
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DOI: 10.1017/S002193200999040X
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K." last="Mbonye">A. K. Mbonye</name><affiliation wicri:level="1"><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Community Health, Ministry of Health, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Hansen, K S" sort="Hansen, K S" uniqKey="Hansen K" first="K. S." last="Hansen">K. S. Hansen</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Health Policy Unit, London School of Hygiene and Tropical Medicine</wicri:regionArea><wicri:noRegion>London School of Hygiene and Tropical Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Wamono, F" sort="Wamono, F" uniqKey="Wamono F" first="F." last="Wamono">F. 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Sci.</title><idno type="ISSN">0021-9320</idno><idno type="eISSN">1469-7599</idno><imprint><publisher>Cambridge University Press</publisher><pubPlace>Cambridge, UK</pubPlace><date type="published" when="2010-03">2010-03</date><biblScope unit="volume">42</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="271">271</biblScope><biblScope unit="page" to="283">283</biblScope></imprint><idno type="ISSN">0021-9320</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0021-9320</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Understanding care-seeking practices and barriers to prevention of mother-to-child transmission (PMTCT) of HIV is necessary in designing effective programmes to address the high disease burden due to HIV/AIDS in Uganda. This study explored perceptions, care-seeking practices and barriers to PMTCT among young and HIV-positive women. A household survey (10,706 women aged 14–49 years), twelve focus group discussions and 66 key informant interviews were carried out between January and April 2009 in Wakiso district, central Uganda. Results show that access to PMTCT services (family planning, HIV counselling and testing and delivery at health units) was poor. Decision making was an important factor in accessing PMTCT services. Socioeconomic factors (wealth quintile, age, education level) and institutional practices also influenced access to PMTCT. Overall, having had an HIV test was highest when both men and women made decisions together or when women were empowered to make their own decisions. This was significant across wealth quintiles (p=0.0001), age groups (p=0.0001) and education levels (p=0.0001). The least level of HIV testing was when men made decisions for their spouses; and this was the case with family planning and deliveries at health units. Other barriers to PMTCT were fear of women and male spouses to have an HIV test and the perception that HIV testing is compulsory in antenatal clinics. In conclusion, to increase access to PMTCT among women, especially the young, poor and least educated, there is a need to empower them to make decisions on health seeking, and also to empower men to support their spouses to make good decisions. Other barriers like fear of having an HIV test should be addressed through appropriate counselling of clients.</div></front></TEI><affiliations><list><country><li>Danemark</li><li>Ouganda</li><li>Royaume-Uni</li></country></list><tree><country name="Ouganda"><noRegion><name sortKey="Mbonye, A K" sort="Mbonye, A K" uniqKey="Mbonye A" first="A. K." last="Mbonye">A. K. 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