Use of Critical Ethnography to Study the PMTCT Program

Abstract

Background: Despite the efforts at establishing Prevention of Mother to Child Transmission (PMTCT) programs in Rwanda, there are still children who are becoming infected through mother-to-child transmission of HIV. The purpose of our research study was to explore the experiences of HIV positive women using PMTCT program to prevent HIV transmission in Rwanda. Methodology: In this study, a qualitative approach using a critical ethnographic design was used to answer to our research question and with the aim to discover the meaning, process, and context of the studied phenomenon. In this paper, we discussed ethnography, critical ethnography, and its related philosophical assumptions as well as illustrating the rational for the use of critical ethnography to study the PMTCT program. Critical ethnography ultimately will contribute to raising awareness on how we can prevent new infections among children born from HIV positive mothers who are using the PMTCT program. The findings suggested a wide range of challenging factors that are shaped by social, political, cultural, economic, ethnic, and gender values, and that directly and indirectly affect the uptake of the PMTCT program. While using the critical realist ontology, we discovered multiple truths about the challenging factors for HIV+ mothers experience to uptake the PMTCT program. We triangulated their experiences with the findings gathered from healthcare providers, PMTCT leaders and policymakers, field observation, and document analysis. No previous studies on this phenomenon used a critical lens to explore the reality behind a wide range of experiences of mothers using the PMTCT program to prevent HIV transmission in Rwanda. Conclusion: The critical nature of this inquiry contributed to the depth and breadth of knowledge related to the delivery of the PMTCT program to prevent MTCT of HIV.