Abstract
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. 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 facilities 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.
Highlights
Initiation of HIV infected infants on Antiretroviral Therapy (ART) reduces infant morbidity and mortality by 75% and 76%, respectively [1,2]
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 Early Infant Diagnosis (EID) service delivery
The factors attributing to the low coverage of EID of HIV services must be promptly addressed to improve service delivery and uptake
Summary
Initiation of HIV infected infants on Antiretroviral Therapy (ART) reduces infant morbidity and mortality by 75% and 76%, respectively [1,2]. Initiating HIV infected infants on ART can only be possible after their HIV status has been ascertained [3] For this reason, the WHO recommends that all exposed infants are virologically tested within 4 to 6 weeks after birth [4]. To ensure that all HIV exposed infants are diagnosed and linked to treatment if found to be infected, an EID cascade ought to be completed. 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
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