Postnatal experiences, perceptions and practices of the Prevention of Mother to Child Transmission of HIV Programme among women enrolled at a Johannesburg Community Health Centre, South Africa

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dc.contributor.author Ngyende, Benon
dc.date.accessioned 2018-07-11T12:02:18Z
dc.date.available 2018-07-11T12:02:18Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/10539/24922
dc.description A Report Submitted in Partial Fulfilment for the Master of Public Health, School of Public Health, University of the Witwatersrand, June, 2017 en_ZA
dc.description.abstract Introduction: South Africa has made great strides to reduce the national rate of mother to child transmission of HIV (MTCT) since the implementation of Prevention of Mother to Child transmission (PMTCT) programme in 2002. However, the programme still faces a number of challenges including the increasing rate of post-natal MTCT. Although many studies have been done on PMTCT in South Africa, there is a scarcity of information on postnatal PMTCT. In particular, there is a dearth of information regarding postnatal experiences, perceptions and, practices among women attending postnatal PMTCT services. Similarly, there is a paucity of data on enablers and barriers to postnatal PMTCT from the users’ perspective. The aim of the study was to explore the postnatal PMTCT experiences, perceptions and practices among women enrolled on the programme as well as to identify the key reported enablers and barriers to their attendance of the programme at a Johannesburg community health centre (CHC), during April-May, 2016. Methodology: Fifteen women enrolled on a PMTCT programme at the CHC participated in the study. A purposive sampling strategy was used to recruit women who have been enrolled on the postnatal PMTCT programme for at least a period of six weeks. A qualitative research design was employed and data were collected through in-depth individual interviews using a standard interview guide. The data was analysed thematically to understand women’s experiences, perceptions and practices in the postnatal PMTCT services. Using both deductive and inductive analysis, various themes emerged from the voices of the women themselves. The analysis of results was guided by the conceptual framing of the study, which drew on Ferguson’s (2013) literature review of women’s experiences in PMTCT services. This literature review presents PMTCT experiences as comprised health services, individual and societal levels. Health services include counselling, confidentiality and health facility factors, individual level includes attitude and beliefs, perception of need and competing obligations while the societal level comprises stigma, gender and legal and policy environment. Results: With respect to postnatal PMTCT women’s experiences, the study identified confidentiality and health facility factors (availability of drugs and easy access to CHC) as key enablers to the postnatal PMTCT services. However, inadequate postnatal PMTCT counselling, sub-optimal health worker-client interactions (uncaring, rude, judgemental, disrespectful and discriminatory attitudes) and health facility factors (long waiting times, queuing at different departments within the CHC and shortage of the postnatal PMTCT staff) were identified as key barriers to these services. The study identified adequate knowledge on the postnatal PMTCT as enabler, while competing obligations and ART side effects were identified as key barriers to the postnatal PMTCT from individual-level perspective. Furthermore, stigma was identified as the key barrier to the postnatal PMTCT from societal-level perspective. With regard to postnatal PMTCT women’s perceptions, the perceived importance of postnatal PMTCT counselling, the effectiveness of the postnatal PMTCT programme and the convenience as well as cost-effectiveness of exclusive breastfeeding were identified as enablers to postnatal PMTCT. However, negative perceptions of adherence to ART and exclusive breastfeeding were identified as barriers to the postnatal PMTCT from individual-level perspective. With respect to postnatal PMTCT women’s practices, compliance with the follow up clinic visits and adherence to ART were identified as enablers while inadequate practicing of exclusive breast feeding was identified as a barrier to the postnatal PMTCT from individual-level perspective. Conclusion: The South African PMTCT programme has made great progress to curb the rate of MTCT since its implementation. However, many challenges still remain including increasing MTCT among HIV exposed infants during the postnatal period. In order to meet the national goal to eliminate the postnatal MTCT, researchers, health policy makers, individual users and community need to be aware of postnatal PMTCT enablers and barriers at different levels: health services, individual and societal levels. Furthermore, it is critical to improve women participation and ensure optimal outcomes for women and their infants by strengthening the programme enablers as well as addressing the bottlenecks. Key words: Postnatal PMTCT, experiences, perceptions, practices, enablers, barriers en_ZA
dc.language.iso en en_ZA
dc.title Postnatal experiences, perceptions and practices of the Prevention of Mother to Child Transmission of HIV Programme among women enrolled at a Johannesburg Community Health Centre, South Africa en_ZA
dc.type Thesis en_ZA
dc.description.librarian DM2018 en_ZA


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