Attitude Of Health Workers Research Articles

Are urban residents seeking appropriate care for malaria? evidence from an exploratory qualitative study in two cities in nigeria

BackgroundUnplanned and rapid urbanization within Nigerian cities with the attendant environmental consequences may hinder achieving malaria elimination goal. Presently, there are limited qualitative studies on malaria case management and care-seeking patterns by settlement type in urban areas in Nigeria. This study, investigated malaria-related health seeking behaviours among different settlement types in Ibadan and Kano metropolises, Nigeria.MethodsThis qualitative study involved conduct of nine Focus Group Discussions (FGDs) sessions among community members and 20 Key Informant interviews (KIIs) with healthcare providers and community stakeholders in each metropolis. Participants were purposively drawn from three settlement types – formal, informal and urban slum. Pretested FGD and KII guides were used to collect data. Data were subjected to thematic content analysis.ResultsGovernment-owned health facilities especially Primary Health Care (PHC) facilities was a major place identified as where many community members prefer to seek care for suspected malaria infection. Reasons adduced included proximity of facilities and services affordability. A common viewpoint was that most community members in informal and slum communities in both metropolises often patronize Proprietary Patent Medicine Vendors (PPMVs) or drug sellers as the first point for treatment of suspected malaria infection. Adduced reasons included poverty and non-availability of 24 h services in PHC facilities. High cost of treatment, poor attitude of health workers, long waiting time and cultural beliefs were identified as key factors influencing community members’ decision not to seek care in health facilities. It was noted that the rich prefer to seek treatment in private hospitals, while the poor usually visit PHCs or resort to other options like buying drugs from PPMVs or use herbal drugs.ConclusionThe standard practice of seeking care in health facilities was influenced by diverse factors including treatment cost, health workers’ attitude and waiting time in health facilities. A commoner practice of seeking care from patent medicine vendors and herbal drug sellers among informal settlements and slums dwellers calls for public health interventions. Specifically, the provision of free or affordable malaria care in health facilities and patient-friendly environments; and training of non-formal care providers on appropriate malaria care and referral to health facilities are recommended.

Forest and Land Fire Management Strategy in South Sumatra Province through the Penta Helix Model

This study aims to determine whether there is an influence of the level of knowledge of JKN-KIS participants, the attitude of health workers and the accessibility of health facilities simultaneously on the utilization of health services for JKN-KIS participants at Community Health Centers and their networks. The method used in this study is quantitative. A minimum of 99 samples from JKN-KIS participants in the work area of Pematang Panggang III.b Health Center, Mesuji Makmur District, Ogan Komering Ilir Regency. In this study, there were two hypothesis tests, namely the Partial Significance Test (T-Test) and the Simultaneous Test (F-Test). The data analysis technique used descriptive statistical analysis techniques; and multiple linear regression analysis. The results showed that the level of knowledge of JKN-KIS participants did not have a significant effect on the utilization of health services at the Pematang Panggang III.b Health Center, Mesuji Makmur District and its network. The accessibility of health facilities had a positive and significant effect on the utilization of health services for JKN-KIS participants at the Pematang Panggang III.b Health Center, Mesuji Makmur District. The level of knowledge of JKN-KIS participants, the attitude of health workers and the accessibility of health facilities simultaneously had a positive and significant effect on the utilization of health services for JKN-KIS participants at the Pematang Panggang III.b Health Center, Mesuji Makmur District. Prosperous Mesuji.

The Effectiveness of CATIN Class on Pregnancy Readiness of Prospective Brides in The Working Area of Citangkil 2 Health Center, Cilegon City

Prospective brides and grooms are a strategic target group in efforts to improve their health before pregnancy. Before the wedding, many prospective brides and grooms do not have enough knowledge and information about reproductive health in a family, so that after marriage pregnancies are often not planned well and are not supported by optimal health status. The number of marriages in Indonesia in 2023 will reach 1.58 million and 68,185 will come from Banten Province. Maternal mortality still reaches 127 cases of maternal death per 100,000 births and the incidence of anemia in pregnant women is 9.2% in 2023. The aim of this research is to determine the effectiveness of prospective brides and grooms or CATIN (Calon Pengantin) classes on the pregnancy readiness of prospective brides in the Industrial Area of ​​the Citangkil 2 Community Health Center, Cilegon City. Research methods is qualitative research. Population in this study were prospective brides and grooms who registered at KUA in July 2024 in the Citangkil 2 Health Center Working Area, Cilegon City, totaling 12 informants, consisting of 10 Catins and 2 expert informants from KUA and Health officers. There is an influence of information sources related to the socialization of the catin class program from KUA officers and Community Health Center Health Workers on the pregnancy readiness of the prospective bride and groom and knowing the attitude of the prospective bride and groom, the attitude of the KUA officers and the attitudes of health workers who take part in the catin class. There is a change in attitude after participating in the catin class service.

Structural barriers and facilitators to accessing HIV services for marginalized working populations: Insights from farm workers in South Africa.

Farm workers are a vulnerable working population that face significant inequalities in accessing health services, including those for HIV prevention, treatment, and care. This descriptive phenomenological study aimed to explore farm workers' experiences when accessing HIV services, and was conducted in Limpopo province, South Africa. Eighteen in-depth interviews (IDIs) were conducted in four health facilities from two districts, and two focus group discussions (FDGs) were conducted in one of the farms within the province. Purposive and systematic random sampling were used to select study participants. A deductive thematic approach was used to analyze data, informed by the social-ecological model of health. The results reveal that farm workers perceive multiple interdependent factors that inhibit or enable their access to HIV healthcare services. Key barriers to HIV healthcare were transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities, and difficult working conditions. Key facilitators to HIV healthcare included the availability of mobile health services, the presence of community health workers, and a supportive work environment. The findings suggest disparities in farm workers' access to HIV services, with work being the main determinant of access. We, therefore, recommend a review of HIV policies and programs for the agricultural sector, and models of HIV healthcare delivery that address the unique needs of farm workers.

Factors Influencing the Utilization of Health Services for JKN-KIS Participants (Study: Grilled Pematang III.B Health Center, Mesuji Makmur District, Ogan Komering Ilir Regency)

This study aims to determine whether there is an influence of the level of knowledge of JKN-KIS participants, the attitude of health workers and the accessibility of health facilities simultaneously on the utilization of health services for JKN-KIS participants at Community Health Centers and their networks.The method used in this study is a quantitative method. Minimum of 99 samples from JKN-KIS participants in the work area of ​​Pematang Panggang III.b Health Center, Mesuji Makmur District, Ogan Komering Ilir Regency. In this study, there were two hypothesis tests, namely the Partial Significance Test (T-Test) and the Simultaneous Test (F-Test). The data analysis technique used descriptive statistical analysis techniques; multiple linear regression analysis. The results showed that the level of knowledge of JKN-KIS participants did not have a significant effect on the utilization of health services at the Pematang Panggang III.b Health Center, Mesuji Makmur District and its network. The accessibility of health facilities had a positive and significant effect on the utilization of health services for JKN-KIS participants at the Pematang Panggang III.b Health Center, Mesuji Makmur District. The level of knowledge of JKN-KIS participants, the attitude of health workers and the accessibility of health facilities simultaneously had a positive and significant effect on the utilization of health services for JKN-KIS participants at the Pematang Panggang III.b Health Center, Mesuji Makmur District, Prosperous Mesuji.

Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Reproductive Health in Nigeria.

Adverse gender norms within the health care system are detrimental to the sexual and reproductive health of young people. This study assessed the attitudes of health workers toward adverse gender norms related to intimate partner relationships across three domains: intimate partner violence (IPV); sexuality; and reproductive health behavior. A cross-sectional quantitative survey was conducted among 255 health workers in youth-friendly primary health centers in Ebonyi State, Nigeria. Attitudes to gender norm statements were assessed on a 3-point scale of agree (3 points), partially agree (2 points), and disagree (1 point). Mean attitude scores were estimated for each statement and the predictors of attitudes were determined through multiple linear regression analysis with p-value set at .05. Majority of the health workers held gender biases regarding male control over sexual decision-making, men's higher desire and value for sex, and the woman's responsibility to prevent pregnancy. Over 40% of the respondents associated women carrying condoms with promiscuity, and 39.6% believed that only men have the "social" rights to purchase condoms. Urban residence predicted health workers' attitudes to adverse gender norms related to sexuality (β = -.179, p = .003). Findings from this study provide a basis for in-service training programs that are designed to change the attitudes of health workers to adverse gender norms and transform their practices.

AFFECTING FACTORS DENTAL AND ORAL HYGIENE STATUS IN SCHIZOPHRENIA

Background: Schizophrenia sufferers generally have poor oral hygiene status, this is because schizophrenic sufferers experience cognitive limitations and the ability to think rationally, resulting in an inability to perform oral hygiene. Research that explores external factors related to dental and oral hygiene status in schizophrenia is still very limited. The aim of this study was to analyze the factors that influence dental and oral hygiene status in schizophrenia. Method. This research is an analytical observation with a cross sectional approach in the work area of ??the Aceh Mental Hospital. The population in this study was all health workers in the schizophrenia room at the Aceh Mental Hospital, totaling 135 people. The sample was taken by purposive sampling, totaling 57 people, the sample size was determined using the TaroYamane formula. Results. This research shows that the level of knowledge and attitude of room health workers is in the good category, but the dental and oral hygiene status of schizophrenic sufferers is still in the poor category, namely 51.3% and 52.3% with a P value > 0.05 which shows that despite their knowledge and The attitude of health workers is in the good category but is not reflected in the dental and oral hygiene status of schizophrenia sufferers. Conclusion. There was no significant relationship between the knowledge and attitude of health workers in the room and the status of dental and oral hygiene in schizophrenia patients.

Factors Affecting Quality of Health Care Services in Government Facilities in Kakindo Health Centre IV in Kakumiro District

This study aimed to examine the factors that affect quality of health services in Kakindo Health Center IV in Kakumiro District. The study used a cross-sectional design using a quantitative approach on the population which was under study. Data was collected using questionnaires, processed in excel, and word using SSP software for correlation purposes. The study found a high significant relationship between health-related factors, health worker related factors and quality of health service delivery. Patient related factors had a low significance. The study concluded that the quality of health services depends on the level to which the management of the facility provides the employees with a conducive work environment. appropriate knowledge and skills, and positive attitude of health workers towards patients was emphasized. health workers were argued to carry out daily patient education in order to change their traditional beliefs. Grading the facility to a level of Hospital this would help to build more infrastructure for both patients and staffs, for security of both patients and staff, the facility needs tapped water so that staff can access clean water inwards, especially the paediatric ward, theatre, general ward, outpatient department, A R T Clinic Cold chain unit and a few staff quarters. A proper fence must be put constructed at the facility. Keywords: Health service, Health workers, Patients, Delivery, Staff

ANALYSIS BETWEEN KNOWLEDGE AND ATTITUDES OF PARENTS REGARDING PROVIDING DOUBLE IMMUNIZATION AT THE MINASA UPA COMMUNITY HEALTH CENTER

Immunization is the act of providing immunity against a disease by introducing specific substances into the body. The completeness of immunization can be influenced by several factors such as knowledge, attitudes, number of children, health worker attitudes, family support, distance from home, education, socio-cultural factors, and community trust. This study aims to determine the relationship between parental knowledge and attitudes toward administering double immunization in infants conducted at the Minasa Upa Community Health Center. The research method used was quantitative research with an observational analytic design with a cross-sectional approach and a non-probability sampling method with a purposive sampling technique, resulting in 85 samples. The study results found that most respondents had good levels of knowledge, with 46 respondents or 54.1%, and exhibited positive attitudes, with 43 respondents or 50.6%. The highest number of respondents who administered double immunization to infants were found to have good knowledge, accounting for 67.4%, with a P-value of 0.003. Meanwhile, the number of respondents who administered double immunization and had positive attitudes was 69.8%, with a P-value of 0.001. Based on this research, it can be concluded that there is a significant relationship between parental knowledge and attitudes towards the administration of double immunization in infants.

Hubungan Sikap Petugas Kesehatan Dengan Kepuasan Pasien Di Poli KIA UPTD Puskesmas I Denpasar Timur

Background: The high maternal mortality rate (MMR) indicates that maternal and child health (KIA) services must be improved. Applying a positive attitude to all patients is a way that health workers can increase patient satisfaction so that patients are interested in undergoing antenatal care to reduce MMR. Objective: This study aims to determine the relationship between the attitude of health workers and patient satisfaction at the Maternal and Child Health Polytechnic (KIA) UPTD Puskesmas I East Denpasar Method: This research uses a correlation analytical design with a cross-sectional study approach. Sampling used a non-probability sampling technique, namely consecutive sampling. The sample used was 172 respondents and the instrument used was a questionnaire. Results: The results of the study showed that of the 172 respondents, the majority of respondents, namely 94 (54.7%) stated that the attitude of health workers was in the positive category and the majority of respondents, namely 90 (52.3%) stated that they were satisfied with the services provided by health workers. The results of the Spearman Rho test show that there is a significant relationship between the attitude of health workers and patient satisfaction, with a p-value <0.001 Conclusion: The more positive the health worker's attitude, the more satisfied the patient. So it is hoped that health workers can apply a friendly attitude, be polite and have empathy for all patients in order to increase patient satisfaction and reduce MMR

Influencing Factors Attitude Health Workers in Patients Mental Disorders

The negative view experienced by individuals with mental disorders will have an impact on the attitude of health workers in providing services at health service facilities. The aim of this research is to identify the factors that influence the attitude of health workers towards patients with mental disorders. This quantitative research was conducted at the District Health Center. Fakfak-West Papua at 127 workers using a purposive sampling technique. Data collection used a self-developed attitude scale, the MHKQ and GSES scales. Data analysis uses multivariate tests using regression. The results of the research obtained significant values for the relationship between various health worker attitude factors, including: There is an influence between mental health literacy (P 0.048<0.005), self-efficacy (P0.001<0.005), R2=0.335. The research conclusion is that there is a significant influence of mental health literacy and self-efficacy on the attitude of health workers in patients with mental disorders, with an influence of 33.5%. It is hoped that the Health Service and Community Health Centers can pay attention to the factors that influence the attitude of Health workers in serving patients with mental disorders so that they can provide better services.

Results of the study of the attitude оf medical workers towards their health

The life expectancy of health workers is worse than average, as they spend little time on maintaining their own health. Health workers should be encouraged to lead a healthy lifestyle constantly and everywhere; they should be an example of healthpreserving behavior. Target. To study the attitude of health workers to their health and their compliance with healthy lifestyle rules. Results. The attitude of health workers to their health was analyzed, and the reasons preventing specialists from maintaining their health were identified. Conclusion. Considering that health workers are people who, by virtue of their profession, have the deepest knowledge about maintaining health and the occurrence of diseases, they should not only bring people knowledge about a healthy lifestyle, but also be an example for them.

Interprofessional collaboration practices: Health worker’s perceptions in private hospital Surabaya

Background: The quality of services provided by hospitals is the responsibility of a group of multi-professional teams working with different professional backgrounds, resulting in inter-professional conflicts that cause losses. To produce quality services, building Interprofessional Collaboration (IPC) among health workers is very important. One of the challenges that prevents the implementation of IPC from working efficiently is the varying opinions of health workers regarding interprofessional collaboration activities. Objective: The goal of this study was to investigate the attitudes of health workers concerning the practice of IPC in hospitals. Method: This research was an observational study employing a cross-sectional strategy. Health workers' impressions of interprofessional cooperation practices were analysed using the Collaborative Practice Assessment Tool for health workers. Result: This study involved 105 health professional respondents. The findings of the questionnaire analysis indicated significant differences in the domain of Relationship among Team Members (p 0.027), Team Relationship with the Community (p 0.012), Leadership (p 0.009), and Mission, Goals, and Objectives (p 0.001). Conclusion: Based on research findings, there are differences in perceptions among health workers because each professional competency domain is different. Therefore, interprofessional education is necessary to illustrate the implementation of collaborative practices across various professions.

Analysis of Health Workers’ Preparedness Factors in Disaster Management at Disaster Prone Area Community Health Centers

Indonesia is one of the most disaster-prone countries in the world. Around 87% of Indonesia's territory is prone to natural disasters. Floods are the most common natural disasters that hit Indonesia. Throughout 2018-2020, South Kalimantan experienced 73 floods. This research aims to analyze the knowledge and attitudes of health workers in disaster management regarding flood disaster preparedness at the Mataraman Community Health Center, Banjar Regency. Quantitative research was conducted using an analytical observational research method with a cross-sectional design. The population in this study were health workers who worked at the Mataraman Community Health Center, Banjar Regency. This study used a sample of 33 people with purposive sampling technique. The instrument used was a questionnaire. Data analysis was carried out using the chi-square test with a confidence level of 95%. The results of statistical tests between the knowledge and attitudes of health workers in disaster management on disaster preparedness with p-values of 0.555 and 0.708. In conclusion, there is no relationship between the knowledge and attitudes of health workers in disaster management on flood disaster preparedness at the Mataraman Community Health Center.

Barriers and facilitators to community acceptability of integrating point-of-care testing to screen for sickle cell disease in children in primary healthcare settings in rural Upper East Region of Northern Ghana.

Sickle cell disease (SCD) remains a public health problem especially in sub-Saharan Africa including Ghana. While pilot initiatives in Africa have demonstrated that neonatal screening coupled with early intervention reduces SCD-related morbidity and mortality, only 50-70% of screen-positive babies have been successfully retrieved to benefit from these interventions. Point-of-care testing (POCT) with high specificity and sensitivity for SCD screening can be integrated into existing immunization programs in Africa to improve retrieval rates. This study explored community acceptability of integrating POCT to screen for SCD in children under 5 years of age in primary healthcare facilities in Northern Ghana. This was an exploratory study using qualitative research approach where 10 focus group discussions and 20 in-depth interviews were conducted with community members and health workers between April and June 2022. The recorded interviews were transcribed verbatim after repeatedly listening to the recordings. Data was coded into themes using QSR Nvivo 12 software before thematic analysis. Most participants (70.9%) described SCD as serious and potentially life-threatening condition affecting children in the area. Of 148 community members and health workers, 141 (95.2%) said the screening exercise could facilitate diagnosis of SCD in children for early management. However, discrimination, fear of being tested positive, stigmatization, negative health worker attitude linked with issues of maintaining confidentiality were reported by participants as key factors that could affect uptake of the SCD screening exercise. Most participants suggested that intensive health education (78.3%), positive attitude of health workers (69.5%), and screening health workers not being biased (58.8%) could promote community acceptability. A large majority of participants viewed screening of SCD in children as very important. However, opinions expressed by most participants suggest that health education and professionalism of health workers in keeping patients' information confidential could improve the uptake of the exercise.

Factors Associated with Use of Traditional Birth Attendants for Child Delivery: A Cross-Sectional Study.

Even though the use of skilled birth attendants at birth reduces the risk of maternal mortality and associated complications, some pregnant women prefer to use either traditional birth attendants (TBAs) or deliver at home. Although the use of assisted delivery was reduced between 2014 and 2016 in North Tongu, the rate of TBA use among pregnant women in the district was increasing. There is, therefore, the need to establish the reason for this increase in TBA use. We conducted a study to assess factors that influence the use of TBAs in the North Tongu district. A retrospective cross-sectional facility-based survey was conducted among 449 women who delivered within the past 12 months and were accessing postnatal care services in the North Tongu district. A simple random sampling method was used to select women who attend child welfare clinics. Bivariate and multivariate analyses were conducted to determine the factors that were significantly associated with use of TBAs. All statistical analyses were done at a 95% confidence level with statistical significance at p ≤ 0.05. The mean age of the respondents was 27.0 years ± 6.2 SD. The prevalence of use of TBA during childbirth among women was 26.5%. Factors that significantly influenced use of TBAs during childbirth were age, religion, educational status, and parity. Other significant factors included several antenatal care visits and the attitude of health workers toward pregnant women. Use of TBA services at birth in the study district remains relatively high. Women who use antenatal and postnatal care services should be educated on the importance of skilled delivery. There is also a need to equip TBAs and reposition them as link agents to facilitate referrals of pregnant women to health facilities where there is a need for additional birth attendants.

Analysis of the implementation of the exclusive breastfeeding policy in the working area of Panombean Panei Health Center

Abstract According to Government Regulation No. 33 of 2012 it is stated that Exclusive Breast Milk, hereinafter referred to as Exclusive Breast Milk, is breast milk given to babies from birth for 6 (six) months, without adding and/or replacing it with other food or drinks. . The impact if the mother does not give exclusive breastfeeding, the baby will be at risk of experiencing health problems and being susceptible to infection. This research is a descriptive qualitative research. The research was conducted at the Panombean Panei Health Center. The research informants were 7 people, the samples were taken by snowballing. Data were analyzed in depth in narrative form by means of data reduction, data presentation, drawing conclusions/verification.The results of the study show that the implementation of the exclusive breastfeeding program at the Panombean Panei Health Center has not been maximized, for the last 4 years the average <40% is still far from the national target of 85%. Bureaucratically, the parties responsible for and involved in the exclusive breastfeeding program are the head of the Puskesmas, the MCH program holder, the nutrition program holder, and the village midwife. Recording and reporting is carried out by the village midwife every month and the health center reports to the Simalungun District Office at the beginning of the month. The resources of health personnel in promoting the exclusive breastfeeding program are sufficient. ASI corner is available but not utilized. Facilities and infrastructure for counseling are still lacking such as leaflets and booklets. The source of funds comes from Health Operational Assistance (BOK) combined with other MCH programs. There is no charge for the implementation of the exclusive breastfeeding program. The disposition or attitude of health workers is good and friendly in providing counseling about exclusive breastfeeding, providing information that is easily understood by mothers. Not all mothers can attend posyandu because of work. Supervision is not carried out specifically and the sanctions are only in the form of a warning. Communication in the implementation of the exclusive breastfeeding program was carried out by health workers by going into the field providing counseling or education by cooperating with the village midwife by forming a class for pregnant women and a class for babies. The frequency of counseling is not routine because the area of the Panombean Panei Health Center is wide. Keywords: Application of Policy, Exclusive Breastfeeding Program, Health Center

Pengalaman Pasien dalam Pemanfaatan Layanan Rawat Jalan di Poliklinik Bedah RSUD S. K. Lerik Kota Kupang

Patient experience is a valuable experience evaluation of a person's satisfaction with processes and services from the patient's perspective. Based on Google user reviews regarding RSUD S. K. Lerik, Kupang City, some complained about poor online registration, long waiting times which resulted in a patient suffering from gastric disease having to be treated in the ER unit. Initial observations on 15-17 November 2022 revealed that there was a delay in service. This study aims to explore the experiences of outpatients regarding services at the S. K. Lerik Regional Hospital, Kupang City. This research is of a qualitative type with a phenomenological research model. There were eight informants in this study who were taken using purposive sampling techniques. The results of research on seven aspects, namely access, patient feelings, treatment, attitudes of health workers, support, obstacles and hopes, show two categories of experience. First, the experience that is categorized as good is easy access to facilities, a clean and safe environment, good communication between medical personnel and patients, medical personnel always maintain hand hygiene, fast examination times, patients receive emotional support. Second, experiences that were categorized as poor were BPJS patients buying infusion fluids and gauze at their own expense, patient communication with inpatient staff was poor, TVs were not used, waiting times were long, and services did not start on time. It is hoped that RSUD S. K Lerik, Kupang City can improve the quality of service for a better patient experience when utilizing health services.

A qualitative examination of factors influencing pregnancy-related anxiety in Northern Ghana

IntroductionDespite high prevalence of anxiety among pregnant women in low- and -middle-income countries, research on context-specific conceptualisation, measurement, and predictors of pregnancy-related anxiety (PrA) is limited in these contexts. We explored local conceptualisations of factors influencing PrA in the Northern Region of Ghana. MethodsWe conducted 15 focus group discussions with antenatal care seekers in the Mion District, Savelugu Municipality, and Tamale Metropolis of the Northern Region, in July and August 2021. Multistage stratified purposive sampling was used to select respondents (n = 108). The data were audio-recorded and transcribed, and then we conducted a thematic analysis of the data. ResultsAt the individual level, fear of anaemia; pre-existing health conditions; challenges with daily activities; and physical, emotional, and sexual abuses from spouses contributed to PrA. Health system failures resulting in unexpected out-of-pocket payments, negative health worker attitudes, diagnostic errors, constraints on birth preparation and birth process, and potential adverse birth outcomes were understood as driving PrA. Socio-cultural factors influencing PrA comprised beliefs and practices around baby naming/outdooring ceremonies, fear of spiritual attacks, social construction of gender roles, and contextual factors such as transportation challenges. ConclusionPregnant women in the region understood, experienced, and could identify perceived predictors of PrA. To address PrA, we recommend that mental health services should be integrated into the basic package of antenatal care and rural health services should be improved. Perceived predictors of PrA identified here could be included in the design of a context-specific PrA measure for use in the region.

HIV prevalence among children admitted with severe acute malnutrition and associated factors with mother-to-child HIV transmission at Mulago Hospital, Uganda: A mixed methods study.

Despite global efforts to eliminate mother-to-child-transmission of HIV (MTCT), many children continue to become infected. We determined the prevalence of HIV among children with severe acute malnutrition (SAM) and that of their mothers, at admission to Mwanamugimu Nutrition Unit, Mulago Hospital, Uganda. We also assessed child factors associated with HIV-infection, and explored factors leading to HIV-infection among a subset of the mother-child dyads that tested positive. We conducted a cross-sectional evaluation within the REDMOTHIV (Reduce mortality in HIV) clinical trial that investigated strategies to reduce mortality among HIV-infected and HIV-exposed children admitted with SAM at the Nutrition Unit. From June 2021 to December 2022, we consecutively tested children aged 1 month to 5 years with SAM for HIV, and the mothers who were available, using rapid antibody testing upon admission to the unit. HIV-antibody positive children under 18 months of age had a confirmatory HIV-DNA PCR test done. In-depth interviews (IDIs) were conducted with mothers of HIV positive dyads, to explore the individual, relationship, social and structural factors associated with MTCT, until data saturation. Quantitative data was analyzed using descriptive statistics and logistic regression in STATAv14, while a content thematic approach was used to analyze qualitative data. Of 797 children tested, 463(58.1%) were male and 630(79.1%) were ≤18months of age; 76 (9.5%) tested positive. Of 709 mothers, median (IQR) age 26 (22, 30) years, 188(26.5%) were HIV positive. Sixty six of the 188 mother-infant pairs with HIV exposure tested positive for HIV, an MTCT rate of 35.1% (66/188). Child age >18 months was marginally associated with HIV-infection (crude OR = 1.87,95% CI: 1.11-3.12, p-value = 0.02; adjusted OR = 1.72, 95% CI: 0.96, 3.09, p-value = 0.068). The IDIs from 16 mothers revealed associated factors with HIV transmission at multiple levels. Individual level factors: inadequate information regarding prevention of MTCT(PMTCT), limited perception of HIV risk, and fear of antiretroviral drugs (ARVs). Relationship level factors: lack of family support and unfaithfulness (infidelity) among sexual partners. Health facility level factors: negative attitude of health workers and missed opportunities for HIV testing. Community level factors: poverty and health service disruptions due to the COVID-19 pandemic. In this era of universal antiretroviral therapy for PMTCT, a 10% HIV prevalence among severely malnourished children is substantially high. To eliminate vertical HIV transmission, more efforts are needed to address challenges mothers living with HIV face intrinsically and within their families, communities and at health facilities.