MOTHERS PERCEPTIONS OF SELECTED FACTORS INFLUENCING AWARENESS OF PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV (PMTCT) SERVICES IN RIFT VALLEY PROVINCIAL GENERAL HOSPITAL, NAKURU.KENYA

ABSTRACT
Prevention of Mother-to-Child Transmission of HIV services is very essential in this era of HIV/AIDS. In effect, the Ministry of Health through various organizations and donors have come up with a comprehensive PMTCT service package to combat transmission of HIV to infants and also keep the mothers healthy. However, there are still very high rates of HIV infection among women and young girls that has resulted to high number of deaths among infants. This study therefore was to establish mothers‟ perceptions of selected factors influencing awareness of PMTCT services at the Rift Valley Provincial General Hospital, Nakuru. The population of study was 217 pregnant women who attended ANC and PMTCT clinic at the Rift Valley General Hospital. Case study design was used and the data was collected by use of a questionnaire designed by the researcher. The results were analyzed and represented using frequencies, percentages, and Chi-square. Statistical Package for Social Science, (SPSS) was used for data analysis. The response rate of questionnaire was 97.7%. It was established that the majority of the respondents indicated that they were moderately aware of PMTCT Services compared to those who indicated that they were highly aware of the PMTCT Services. It was also established that the majority of the respondents perceived counseling as moderately effective on PMTCT Services as compared to those who perceived it as highly effective. The research recommends a need to scale up awareness campaign of PMTCT Services through public meetings, support groups and mass media to breach the gap between awareness and intake of the services. The HIV Counseling and testing should be normal ANC routine service, to enable pregnant women to make informed decision about their pregnancy and receive appropriate and timely interventions to reduce MTCT of HIV. The findings may be generalized to Rift Valley Province and other similar areas where PMTCT services are provided but with caution.

CHAPTER ONE:
INTRODUCTION
Background of the Study
The World Health Organization (WHO) estimates that 40 million people are living with HIV/ AIDS worldwide and 28 million in sub-Saharan Africa whereby 2.2 million are in Kenya (WHO, 2007). The report further indicates that 55% of the infected are women in their child bearing age (15-49 years). This indicates that women and girls are the growing proportion of those infected by HIV/ AIDS, prompting the initiation of various preventive programmes of which mother-to- child transmission of HIV is one of them.

Heterosexual transmission is the major route to HIV infection in sub-Saharan Africa, Kenya included, resulting to 60% of women adults living with the virus (Center for Disease Control CDC, 2007). The report further indicated that over 2.2 million Kenyan adults are dying with HIV/ AIDS. Out of the 2.2 million, 1.5 million are women and yet the prevalence had gone down from 6.1 to 5.1 in 2006. According to NASCOP (2007), the prevalence is low but 1.5 million pregnant women need counseling and testing to determine their status whereas 68,000 need to prevent HIV transmission to infants In 2008 NASCOP revealed that the prevalence had gone up from 1.5 to 1.7.This was revealed from a research carried out on sampled PMTCT Centre countries wide which indicate low awareness of PMTCT services. It was due to the disparities between prevention, death, effectiveness of counseling and awareness that the study attempts to establish awareness levels effectiveness of counseling and other factors on prevention of mother- to-child transmission of HIV (PMTCT) services among pregnant women attending antenatal clinic at the Provincial General Hospital Nakuru, Kenya.

The Mother-to-Child Transmission of HIV (MTCT) is one of the consequences of HIV/AIDS transmission (World Change Program, 2007). The program indicates that women have 10% prevalence, while men have 5% which indicates high transmission of HIV to infants and mothers. This has drawn more attention to research on saving the children from the scourge of HIV and ignoring the mothers who are equally infected.

Thus, an in-depth study was necessary on mothers‟ perceptions of selected factors influencing awareness levels of HIV (PMTCT) services

In Kenya, over 50,000 infants are born with HIV and out of 1.3 million births annually there was a very small number born with negative status (CDC, 2006). These overwhelming figures have prompted research to be carried out including PMTCT programs.

The Ministry of Health (MOH) through National AIDS Control and Prevention has taken several measures in carrying out programmes especially for the mother and children like maternal child care, but still there are high infections and more deaths. The PMTCT services provision was a (MOH) initiative to extend the services to all parts of Kenya targeting 80% by 2007 (MOH 2003, National Health Program & Strategic Planning, 2003-2007). It was for this reason that the proposed research was designed to carry out an in-depth study on the mothers perceptions of selected factors influencing awareness levels of HIV (PMTCT) services in the Provincial General Hospital Nakuru, Kenya.

Statement of the Problem
According to the Kenya NASCOP (2007), 10% of the reported deaths of infants are due to Mother to Child Transmission of HIV in Kenya. This death and transmission rate may have been avoided if pregnant mothers were aware of PMTCT services. A few researchers have tried to carry out studies on prevention of mother-to child transmission of HIV. For instance World Change Program (2007) researched on mother to child transmission of HIV (MTCT). Pathfinder International (2003-2007) and Avert Organization (2006) researched on save the child from the scourge of HIV. From available literature there is no in-depth study that has been carried out on mothers‟ perceptions of selected factors influencing awareness levels of HIV (PMTCT) services. Against this backdrop, the current study aimed to establish the mothers‟ perceptions of selected factors influencing awareness of HIV (PMTCT) services. These factors include counseling, information, poverty, female genital mutilation domestic violence, early marriages, and fear of disclosure, age, stigma and discrimination in the Rift Valley Provincial General Hospital Nakuru.

Purpose of the Study
The purpose of the study was to establish the mothers‟ perceptions of selected factors influencing awareness of PMTCT services at Provincial General Hospital Nakuru, Kenya

Objectives of the study
The following objectives guided the study:

a) To establish awareness of PMTCT services among mothers attending ANC at Rift valley Provincial General Hospital Nakuru.

b) To establish the mothers perceptions of the following selected factors influencing awareness of PMTCT services at Rift valley Provincial General Hospital Nakuru

(i) Counseling

(ii) Provision of information

(iii) Poverty and female genital mutilation

(iv) Domestic violence and early marriages

(v) Fear of disclosure, Stigma and discrimination

(vi) Age

Research Questions
a) What were the awareness levels of PMTCT services among mothers attending ANC at Rift Valley Provincial General Hospital Nakuru?

b) What were the mothers‟ perceptions of the following selected factors influencing awareness of PMTCT services at Rift valley Provincial General Hospital?

(i) Counseling

(ii) Provision of information

(iii) Poverty and female genital mutilation

(iv) Domestic violence and early marriages

(v) Fear of disclosure, Stigma and discrimination

(vi) Age

Significance of the Study
The research findings may be beneficial to all mothers of child bearing ages since it may be used to encourage them to go for PMTCT services wherever they are. The information may enable the infected and affected to create awareness on PMTCT services and therefore increase awareness levels.

The Ministry of Health may use the findings to scale up the PMTCT services to reach those who have not got the services. The Non-Governmental Organization (NGOS) may use the findings to fund awareness campaigns on PMTCT services and also to provide antiretroviral treatment (ART). MOE can also use this information to include guidance, counseling, and teaching of life skills in schools so as to reach the infected like female teachers in primary, secondary, colleges and affected children.

Scope of the study
The study was carried out at the Antenatal clinic of Rift Valley Provincial General Hospital Nakuru, Kenya. It was confined to the mothers‟ perceptions of selected factors influencing awareness of PMTCT services.

Limitations of the study
The study was limited only to pregnant mothers where by some could refuse the questionnaire due to fear that they do not know what they are being asked but the questionnaires were availed every day until the sample of 217 was attained.

Assumptions of the Study
The study was based on the following assumption

i) All the pregnant women attending ANC benefit from the PMTCT Services.

ii) The PMTCT services are available for all mothers free of charge.

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Item Type: Kenyan Material  |  Attribute: 59 pages  |  Chapters: 1-5
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