THE INFLUENCE OF PREVENTION OF MOTHER-TO-CHILD HIV TRANSMISSION CAMPAIGNS ON KNOWLEDE, ATTITUDE AND PRACTICES AMONG WOMEN IN SOUTHEAST NIGERIA

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CHAPTER ONE

INTRODUCTION


1.1        Background of the Study
The scourge of HIV/AIDS has, no doubt, continued to ravage virtually all parts of the world. According to statistics, 34 million people are estimated to be living with HIV worldwide; 16.7 million of these are women and 3.4 million are children younger than 15 years of age. In 2011, a total of 2.5 million people were newly infected with HIV globally; an estimation of 330 thousand of these new infections are children under 15 years of age. Also in 2011, the world recorded 1.7 million deaths orchestrated by AIDS of which 230 thousand children under 15 years of age were involved (UNAIDS, 2012).


Sub-Saharan Africa (including Nigeria), with more than two-third of the world’s total number of HIV-infected people, remains the region most affected by the HIV/AIDS pandemic. About 68% of all the people living with HIV reside in sub-Saharan Africa, a region with only 12% of the global population. The region also accounted for 70% of new HIV infections in 2010 while in 2011, an estimate of 270,000 children in sub-Saharan Africa were newly infected with HIV. AIDS has claimed at least, one thousand lives annually in sub-Saharan Africa since 1998 (UNAIDS, 2012 and 2011).

According to the National Agency for the control of AIDS (NACA), Nigeria has an estimated 3.1 million people living with HIV/AIDS, with an annual HIV positive births of 56, 681, a cumulative AIDS deaths of 2.1 million and an annual AIDS death of 215, 130 people (NACA, 2011). Statistics from the agency further show that an estimated 281, 180 new HIV infections have been recorded; 126, 260 are adults while 154, 920 children were involved in the new infections. Women, however, constitute 57% of adults infected with HIV in the country (NACA, 2011, FMOH and MASI, 2006). The pandemic is, no doubt, having a serious effect on the reproductive health of women (Adeleke, Mukhtar and Gwarzo, 2009, p.21).

HIV is the leading cause of mortality among women of reproductive age worldwide and is a major contributor to maternal, infant and child mortality. Without treatment, one third of children living with HIV die before they reach one year of age and 50% die by the second year of life (WHO and UNAIDS, 2009).

Globally, the number of women dying from AIDS related cases during pregnancy or within 42 days after pregnancy was estimated to be 37 million. Also, among the 21 high priority countries (including Nigeria), 33,000 pregnancy – related deaths among women were recorded (UNAIDS, 2012 and 2011). Statistics also indicate that maternal mortality was still very high in Nigeria (630/100,000 live births) (UNAIDS, 2011).

From the figures presented above, it is very correct to aver that in all the HIV infections and deaths, children have continued to be seriously victimized. One avenue that has fundamentally aided the infection of children with this deadly disease (HIV) is Mother-to-Child Transmission (MCT). This has, no doubt, served as a major pathway for the spread of the HIV virus. For instance, in Nigeria alone, UNAIDS reported that an estimated 84, 200 children were newly infected with HIV through mother-to-child transmission in 2009. To this end, the World Health Organisation (WHO) in 2010 reported that the prevention of mother-to-child transmission of HIV (PMTCT) has been at the forefront of global HIV prevention activities since 1998.

The transmission of HIV from an HIV positive mother to her child during pregnancy, delivering or breast feeding is called mother-to-child transmission (WHO, 2010). Children, no doubt, are mainly infected with HIV through mother-to-child transmission at the time of pregnancy, child labor and delivery or through breastfeeding. This has created enormous social and economic problems. Aside the dominant hetero-sexual transmission of HIV, vertical transmission from mother to child accounts for more than 90% of pediatric AIDS. Particularly in developing countries, mother to child transmission has become a critical child health problem (Goncho, 2009, p.6).
The menace of mother to child transmission has been very devastating. Many children have been infected which has resulted to their early deaths. According to a progress report by UNAIDS 2012, an estimate of 3.4 million children younger than 15 years were living with HIV globally in 2011, 919 of them in sub-Saharan Africa (where Nigeria is situated). An estimated 230 thousand children died from AIDS-related illness in the same year.
In the absence of interventions, the range of 20-45% of infants would be infected with the deadly HIV through mother to child transmission during pregnancy. 10-20% of infants would be infected during labour and delivery, while 5-20% will be infected through breast feeding. With appropriate interventions, the overall risk can be reduced to less than 2% (WHO, UNAIDS, UNICEF, 2008) cited in (Goncho, 2009, p.7).
To nip this deadly scourge in the bud, renewed efforts were made to scale-up the prevention of mother-to-child transmission (PMTCT) programmes globally. The Millennium Development Goals (MDGs) adopted by the UN General Assembly in 2010 committed the international community to reducing child mortality; improving maternal health, and combating HIV/AIDS, Malaria and other diseases by 2015. At the UN General Assembly Special Session (UNGASS) in 2001, governments, further committed to reduce by 50% the proportion of infants infected by HIV by 2010 by ensuring 80% of pregnant women accessing antenatal care receive PMTCT services (WHO, 2010, p.11). Also, in 2005, representatives of governments, multilateral agencies, development partners, research institutions, civil societies and people living with HIV assembled at the PMTCT High level global partners forum in Abuja, Nigeria, which resulted in a “call for Action” for the elimination of HIV infection in infants and children and an HIV-and AIDS free generation (WHO, 2007, p.4).
To effectively combat mother-to-child transmission, the United Nations came up with four-pronged strategy for PMTCT which addresses a broad range of HIV related prevention, care, treatment and support needs of pregnant women, mother, their children and families. This comprehensive approach includes four elements-the primary prevention of HIV infection among women, especially young women, the prevention of unintended pregnancies among HIV-infected women, provision of specific interventions to reduce HIV transmission from HIV-infect women to their infants, and provision of treatment, care and support for HIV-infected mothers, their infants and family (FMOH, 2010, p.4-5).
The potential for PMTCT to reduce the risk of HIV transmission to less than 2% of births to HIV-positive mothers underscores the importance of a communication strategy that reaches all relevant stakeholders (CADRE, 2009, p.12). This calls for the provision of adequate information to the general population and relevant service providers on the programme through well coordinated campaigns to create awareness and positively influence attitudes, norms, values, and behaviours of the public regarding PMTCT and to improve the capacity and skills of healthcare providers for standard PMTCT services.

1.2        Statement of the Research Problem
Countless number of HIV prevention campaigns have been going on globally, Nigeria not exempted. The campaigns sponsored by various organizations and bodies such as the World Health Organization (WHO), Society for Family Health...

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