Male partner involvement in efforts to eliminate mother-to-child transmission of HIV in Kisumu County, Western Kenya, 2015.

Elvis Oyugi,Jane Githuku,Waqo Boru,Walter Otieno,Dickens Onyango,Zeinab Gura,Venny Nyambati

doi:10.11604/pamj.supp.2017.28.1.9283

Abstract

Introductionmale partner involvement in elimination of mother-to-child transmission (eMTCT) of HIV activities remains low in Western Kenya, despite its importance in reducing rates of child HIV transmission. We sought to identify factors associated with male partner involvement in eMTCT in Kisumu East sub-County, Western Kenya.Methodswe conducted a cross-sectional study among women aged ≥ 18 years who had children aged ≤ 12 months and were attending a child health clinic for immunization services in one of four Western Kenya health centers between February and April, 2015. We assessed male involvement using an "involvement index" of five factors of equal weight: partner antenatal care (ANC) attendance, partner HIV testing, partner financial support to the woman during ANC, partner awareness of ANC services and partner participation in decision making on contraception including condom use. Male involvement was classified as high or low based on their index score. We calculated odds ratios (OR) and 95% confidence intervals (CI) to identify factors associated with high male partner involvement.Resultswe recruited 216 female participants. Mean age was 26.1 years (± 5.5 years), 189 (87.5%) were married. The majority (94.4%) had attended ANC in public health facilities. Nineteen percent of women had high male involvement. Having > 8 years of formal education (AOR 3.9, CI = 1.51-10.08), having male partner who was employed, history of previous couple testing (AOR = 3.2, CI = 1.42-7.22) and reports of partner having read the mother-child booklet during ANC (AOR = 2.9, CI = 1.30-6.49), were associated with high male involvement.Conclusionbased on our findings, we recommend targeted strategies to actively sensitize men and encourage their involvement in eMTCT, particularly among partners of women with fewer years of education and among partners who are not employed.

Highlights

Caesarean section rates are rising globally, but the determinants of this increase, especially in low-income and middle-income countries, are debatable
We found that mothers who underwent caesarean sections (CS) were at lower odds of having babies with normal birth weights because many of the low birth weight babies are premature and like babies with Cephalo pelvic disproportion are delivered through CS [13,14]
To arrest the factors associated with CS the county department of health should promote focused ante natal care as this will help to identify pre-existing health conditions and detect early complications arising during the pregnancy

Summary

Introduction

Caesarean section rates are rising globally, but the determinants of this increase, especially in low-income and middle-income countries, are debatable. Since the late 70s there have been a steady increase in the proportion of women delivering through caesarean sections (CS). This led the World Health Organization (WHO) in 1985 to state that: "There is no justification for any region to have caesarean section rates higher than 10-15%" [1], since increased rates of CS do not give additional health benefits but may increase maternal risks, have implications for future pregnancies and put more strain on the available health resources [2]. Whereby every third mother who met the definition of a control was recruited into the study. In instances when the third mother didn’t meet the criteria, she was replaced by the consecutive mother that met the definition of a control.

Results

Discussion

Conclusion