Abstract
BackgroundMale involvement (MI) in Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services remains low despite the progress registered in the implementation of the PMTCT program. Male involvement in PMTCT is a fairly new concept in Malawi that has not been fully implemented within PMTCT service provision despite its inclusion in the PMTCT guidelines. One of the reasons for the limited MI is the lack of knowledge on both its relevance and the role of men in the program. Currently, men have been encouraged to participate in PMTCT services without prior research on their understanding of the relevance and their role in PMTCT. This information is vital to the development of programs that will require MI in PMTCT. The objective of this study was to explore the views of men, pregnant women and health care providers on the importance and roles of MI in PMTCT services in Blantyre Malawi.MethodsAn exploratory descriptive qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) and its catchment area in Blantyre, Malawi. We conducted 6 key informant interviews (KIIs) with health care workers and 4 focus group discussions (FGDs) with 18 men and 17 pregnant women. Interviews and discussions were digitally recorded and simultaneously transcribed and translated into English. Data were analyzed using framework analysis approach.ResultsThe major themes that emerged on the relevance of MI in PMTCT were a) uptake of interventions along the PMTCT cascade b) support mechanism and c) education strategy. Lack of MI in PMTCT was reported to result into non-disclosure of HIV test results and non-compliance with PMTCT interventions.ConclusionsMale involvement is paramount for the uptake of interventions at the different cascades of PMTCT. The absence of male involvement may compromise compliance with PMTCT interventions.
Highlights
Male involvement (MI) in Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services remains low despite the progress registered in the implementation of the PMTCT program
Interviews and discussion Interviews with key informants and focus group discussions (FGDs) were guided by the following broad questions (Additional file 2: key informant interviews (KIIs) Guide and Additional file 3: FGD Guide): a) What is the relevance of MI in PMTCT of HIV services?
Relevance of male involvement in the prevention of mother to child transmission of HIV services The major themes that emerged on the relevance of MI in PMTCT were a) uptake of interventions along the PMTCT cascade b) support mechanism and c) education strategy
Summary
Male involvement (MI) in Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services remains low despite the progress registered in the implementation of the PMTCT program. Prevention of Mother to Child Transmission of HIV services has the following cascades that a pregnant woman has to navigate to achieve effective reduction in MTCT of HIV: antenatally the cascades are as follows; a) attendance to antenatal care, b) offered and ability to take an HIV test, c) undergo staging to determine eligibility for ART (does not currently apply in Malawi with Option B + as policy for all pregnant women), d) initiate ART or PMTCT prophylaxis and e) continue with follow up and adherence to ART antenatally. The initial analysis of retention in care under Option B + regimen in Malawi, revealed that 17% of the HIV infected women were lost to follow-up 6 months post ARV initiation and more women dropped out of the group that started ARVs to prevent MTCT compared to those that initiated ARVs secondary to a low CD4 count or for their own health [7]
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