Abstract
HIV and AIDS, in resource-limited settings, contribute to increased maternal and infant mortality where such vital indicators are already high. In these settings, babies born to HIV-positive women continue to have added risks of acquiring HIV infection and dying from it before their fifth birthdays if no interventions are employed. Prevention of mother-to-child transmission (PMTCT) is an international initiative whose implications within the local context need to be known. An operational research approach was adopted to study the demand and adherence of key components within the PMTCT Programme among women in rural Malawi. This study was carried out at Malamulo SDA Hospital in rural Malawi and employed the mixture of both quantitative and qualitative approaches. While the introduction of innovative policies in antenatal care (ANC) that has positive impact particularly on marginalised women's access to the services, negative effects are also inevitable. Marginalised women in resource-poor settings fail to deliver at the health facility due to lack of transportation, economic difficulties, gender inequalities, tradition and negative attitude of health workers. Integration of HIV testing and opt-out testing in ANC coupled with the introduction of free maternal care resulted in more women accessing maternal services and PMTCT services. It is as a result of this that institutional delivery facilitates increased adherence to antiretroviral prophylaxis and is supported by both women and the communities. The paper summarises the research conducted and elaborates on how it contributed to actions to improve staff attitude, increase male involvement in reproductive health care and discussions on how available resources can be maximised.This article has been commented on by Thorkild Tylleskär. Please follow this link – http://www.globalhealthaction.net/index.php/gha/article/view/5370 – to read his Commentary.
Highlights
HIV/AIDS is the deadliest epidemic of our time
This study found that over 87.5% of the women were of the opinion that HIV testing in pregnancy was of benefit to the mother and her baby (Dube and Nkosi, 2008)
Increased accessibility and utilisation of maternal services can increase the coverage of prevention of mother to child transmission (PMTCT) services
Summary
HIV/AIDS is the deadliest epidemic of our time. Over 33 million are currently living with HIV and AIDS worldwide and more than 22 million people have already lost their lives. By the end of 2005, women accounted for nearly half of all the people living with HIV and AIDS worldwide, and represent almost 60% of those infected in sub-Saharan Africa. Malawi has a population of 13 million and is one of the poorest countries in Africa with the gross domestic product (GDP) of USD 257, and over 60% of people live on less than a dollar (IMF, 2008). It is a land locked country and densely populated with a strip of land measuring 118,480 sq km of which 94,080 sq km is land and the rest is water. Malawi’s foreign policy is pro-western and includes positive diplomatic relations with most countries and participation in several international events
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