Knowledge, attitudes and practices of healthcare providers towards prenatal HIV screening and prevention of mother -to-child transmission in nigeria

Abstract

TOWARDS PRENATAL HIV SCREENING AND PREVENTION OF MOTHER -TO-CHILD TRANSMISSION IN NIGERIA L. NNEKA MOBISSON, DONNA NEALE (F), University of Pennsylvania, Pediatrics, Philadelphia, Pennsylvania, Yale University, Maternal-Fetal Medicine, New Haven, Connecticut OBJECTIVE: Over 3.5 million people in Nigeria are living with HIV/AIDS; consequently, the risk of perinatal transmisson is great. The purpose of this study was to assess the knowledge, attitudes and practices of healthcare providers regarding prenatal HIV screening and the use of antiretroviral drugs in the prevention of mother-to-child transmission of HIV in Nigerian pregnant women. STUDY DESIGN: A cross sectional survey using self-administered questionnaires among 150 healthcare providers (physicians and nurses) was conducted at four healthcare facilities in Nigeria from June August 2000. Three of these healthcare facilities are designated pilot centers for the national prevention of mother-to-child transmission (PMTCT) program. Differences in responses between physicians and nurses were compared for each category and at each hospital. RESULTS: Of 150 self-administered questionnaires that were fielded, 86 healthcare providers responded, representing 57% of physicians and nurses. Less than two-thirds of respondents had correct knowledge regarding the use of antiretroviral drugs in mother-to-child transmission with physicians being more knowledgeable than nurses. Despite the difference in knowledge levels, more nurses than physicians acknowledged the importance of screening pregnant women for HIV (93% vs. 70.91%; p = 0.04). In addition, a significantly larger proportion of nurses routinely inquire about the HIV status of pregnant women (60% vs. 38%). CONCLUSION: Current healthcare providers have limited knowledge levels regarding the use of antiretroviral drugs in the prevention of mother-to child transmission. In addition, a significant proportion of healthcare providers do not have attitudes or practices conducive to the prevention of perinatal transmission. This may negatively impact on the success of the PMTCT programs in Nigeria. This study highlights the need for continuous and comprehensive training of healthcare providers at government and private healthcare facilities to increase the likelihood of achieving the objectives of PMTCT programs.