Assessment of utilisation of PMTCT services at Nyanza Provincial Hospital, Kenya

Abstract

The main objective of the study was to assess the utilisation of prevention of mother-to-child transmission (PMTCT) services among mothers registered for services at Nyanza Provincial Hospital in Kenya. A cross-sectional exploratory study was conducted, using both quantitative and qualitative approaches to collect primary and secondary data. The study population was 133 clients registered for PMTCT services. The study revealed that 52.4% of clients received PMTCT information at the health facility without prior knowledge about intervention, 96% waited for more than 90 minutes, and 89% took less than 10 minutes for post-test counselling. Knowledge of MTCT and PMTCT was inadequate even after counselling, as participants could not recall the information divulged during counselling. In addition, 80% of clients did not present for follow-up counselling irrespective of HIV status, and 95% did not disclose positive HIV status to spouses/relatives for fear of stigma, discrimination and violence. Inadequate counselling services delivered to clients affected service utilisation, in that significant dropout occurred at the stages of HIV result (31.5%), enrollment (53.6%), and delivery (80.7%). Reasons for dropout included fear of positive HIV result, chronic illness, stigma and discrimination, unsupportive spouse and inability to pay for the services.

Le but principal de cette étude fut d'évaluer l'utilisation des services PMTCT parmi les mères inscrites aux services de l'hôpital provincial Nyanza. Une étude transversale et exploratoire a été faite durant laquelle les approches quantitatives et qualitatives furent utilisées afin de recueillir des données primaires et secondaires. La population d'étude furent 133 clients inscrits aux services PMTCT. Cette étude a montré que 52.4% de clients ont eu les informations sur le PMTCT au centre médical même sans avoir la connaissance préalable de l'intervention, 96% ont attendu plus de 90 minutes et 89% ont subi la consultation après le dépistage qui a duré moins que 10 minutes. La connaissance sur le MTCT et le PMTCT fut inadéquate même après la consultation, étant donné que les participants ne pouvaient plus se rappeler l'information qu'on leur a donné lors de la consultation. Ceci a aussi démontré 80% de manque de suivi après la consultation sans tenir compte du statut sérologique et 95% ne dévoilent pas leur statut sérologique positif à leur époux(se)/membres de famille de peur de stigmatisation, de discrimination et de violence. Les services de consultation inadéquats mis à la disposition de clients ont un effet sur l'utilisation de services, parce que un grand nombre de clients laissent tombé la consultation après les résultats du dépistage (31.5%), les inscriptions (53.6%) et le service rendu (80.7%). Les raisons de laisser tombé comprennent la peur de connaître son statut sérologique, les maladies chroniques, la stigmatisation et la discrimination, un(e) époux(se) qui n'offre pas de soutien et l'incapacité de payer pour les services.

Keywords:

• utilisation
• PMTCT services
• Nyanza Hospital
• Kenya

Mots clés:

• utilisation
• services PMTCT
• hôpital Nyanza
• le Kenya

Additional information

Notes on contributors

Iscah Akoth Moth

Iscah Akoth Moth is a social scientist who graduated at the Great Lakes University, Democratic Republic of Congo in July 2004. She has worked with the health sector for the last 17 years. Currently she is the District AIDS and STI Coordinator (DASCO) in Rachuonyo District, Kenya. She has been involved in fieldwork in West Kenya since 2001, in partnership with communities in Bondo and Rachuonyo Districts, Kenya.

A.B.C.O. Ayayo

ABC O Ayayo is Professor of Anthropology and the Director of Population Studies at the University of Nairobi. He has done extensive fieldwork in Africa and elsewhere in the world.

Dan Kaseje

Dan Kaseje is the director of the Tropical Institute of Community Health and Development (TICH) in Africa. He is a long-time medical doctor and a chief crusader in community health and development.