Prevalence Of HIV Among Pregnant Women Attending Antenatal

Medical and Health Science Project and Seminar Material

Prevalence Of HIV Among Pregnant Women Attending Antenatal


Abstract


Transmission of HIV from pregnant mothers to their children is a key route of HIV transmission in Nigeria. The current study is on the prevalence of HIV among pregnant women attending antennal.

The study was conducted in ten Primary Health Centres offering antenatal as well as Routine HIV Counseling and Testing services in the selected LGAs in the FCT. It was a descriptive cross sectional study using multistage sampling technique. Data were collected using questionnaires and analyzed using simple percentages and frequencies. Level of confidence was at p=0.05.

Findings showed that there is a decrease in prevalence rate as compared to previous records. The study showed significant associations between socio-demographic and mean knowledge as a factor influencing prevalence rate.It is recommended that; women should be educated on health related issues including PMTCT. This would help cub the rate of mother to child transmission.


Chapter One


Introduction

1.1 Background of the Study

Mothers and children are at highest risk for disease and death. While motherhood is often a positive and fulfilling experience, for too many women, it is associated with ill–health and even death. The death of a woman during pregnancy, labour or pueperium is a tragedy that carries a huge burden of grief and pain, and has been described as a major public health problem in developing countries. Women have an enormous impact on their families’ welfare. Deaths of infants/children under five are peculiar and closely related to maternal health. WHO (2006) Mother-to-child-transmission (MTCT) is the second commonest mode of Huma immunodeficiency Virus infection in most African countries. The risk of HIV transmission from mother to child is estimated at 5-10% during pregnancy; 10-20% during labour and delivery, and 10-20% in the post-partum period. UNICEF (2003).During the year 2003, about 2.5 million (2.1-2.9 million) children were living with HIV/AIDS; and the global HIV/AIDS epidemic had claimed the lives of nearly 4.3 million children. Mother to child transmission (MTCT) is the largest source of HIV infection in children below the age of 15 years and affects approximately 500,000 infants per year all over the world, majority of which are in developing countries. Apart from posing the burden of HIV positive children on the society, MTCT is causing great social problems by producing orphans after the death of one or both parents due to AIDS
http://www.ijppediatricsindia.org/article.asp?issn=0019-5456. HIV is the leading cause of mortality among women of reproductive age worldwide and is a major contributor to maternal, infant and child morbidity and mortality WHO (2009). Without treatment, one third of children living with HIV die before they reach one year of age and over 50% die by the second year of life Newell ML et-al (2005). In 2008, an estimated 1.4 million pregnant women living with HIV in low- and middle-income countries gave birth, 91% of whom reside in sub-Saharan AfricaWHO (2007). Without intervention, 25-40% of infants born to HIV-positive mothers will become infected. With current interventions, this risk can be reduced to less than 5%. Therefore, transmission of HIV from a pregnant woman to her infant is preventable. Effective provision of Prevention of Mother-to-Child Transmission of HIV (PMTCT) interventions improves maternal health and infant HIV-free survival WHO (2009). PMTCT is a key component of overall HIV prevention efforts and represents a critical opportunity for stemming the tide of the HIV epidemic. To successfully reduce mother-to-child transmission of HIV, population-level efforts to prevent HIV infection among women of childbearing age must be realized. For the individual woman, a comprehensive, coordinated continuum of services must be provided beginning with increased access to counseling, testing, and primary prevention services, as well as reproductive health choices enabling either the prevention of unintended pregnancies or appropriate planning for intended future pregnancies for women living with HIV. For HIV-positive women who become pregnant, access to and follow through on effective interventions to prevent transmission to the infant and to provide treatment for the woman herself and her child if infected must be provided6.Nigeria has the second largest HIV burden in the world. While HIV prevalence is on the decline, with 4.1% of the adult population infected, there are more than three million people living with HIV and AIDS in Nigeria. Federal Ministry of Health (2010) Furthermore, HIV prevalence in Nigeria is highly variable, with wide differences in vulnerability found both geographically and by population Federal Ministry of Health (2010). Antenatal data by state shows a range in HIV prevalence from a high of 12.7% in Benue to a low of 1% in Kebbi. Urban areas have generally been harder hit than rural areas, but nine states and the Federal Capital Territory are experiencing the reverse situation. Federal Ministry of Health (2008) The Government of Nigeria is committed to HIV prevention which is guided by the National HIV/AIDS Strategic Plan 2010-2015. Building on momentum gained under the 2005-2009 National Strategic Framework, the current strategic plan emphasizes behaviour change and prevention of new infections while sustaining advances in HIV and AIDS treatment, care, and support. Despite these efforts, deficiencies in the response to HIV remain.


1.2 Statement of the Problem

Transmission of HIV from pregnant mothers to their children is a key route of HIV transmission in Nigeria. About 4.1% of women attending ANC are infected with HIV, resulting in mother-to-child transmission accounting for 10% of all HIV infections in the country. Federal Ministry of Health(2010). This translates to about 57,000 HIV-infected infants born each year. Nigeria contributes up to 30% of the global PMTCT gap and coverage of PMTCT services. It has however remained low at less than 19% – falling short of both the universal access and National Strategic Plan targets. Federal Ministry of Health (2010) To bridge this gap, it has become imminent that pregnant women must be tested when attending antennal in order to improve early detection and ultimately encourage PMTCT, thereby reducing the menace of HIV in Nigeria and the world at large. This research work therefore intends to assess the prevalence of HIV among pregnant women attend antenatal.


1.3 Objective of the Study

The broad objective of the study is to access the prevalence rate of HIV among pregnant women attending antennal. The general objectives of the study are;

  1. To determine and compare knowledge of pregnant women regarding PMTCT the FCT.
  2. To determine and compare attitudes of pregnant women regarding PMTCT in the FCT
  3. To determine and compare practice of PMTCT among pregnant women in the FCT.
  4. To identify factors that influenced Knowledge, Attitude and Practice of PMTCT among pregnant women in the FCT.

1.4 Research Hypotheses

Hypotheses One
  • Ho: Women in the FCT have a good knowledge on the importance of PMTCT
  • Hi: Women in the FCT do not have a good knowledge on the importance of PMTCT
Hypotheses Two
  • Ho: There is no relationship between the knowledge of women on PMTCT and the prevalence of HIV in Nigeria.
  • Hi: There is a relationship between the knowledge of women on PMTCT and the prevalence of HIV in Nigeria.

1.5 Significance of the Study

This knowledge, attitude, practice and prevalence survey intends to identify factors underlying this poor uptake of PMTCT activities in the FCT. The results from the study will help to improve the Prevention of Mother-To-Child Transmission (PMTCT). services in these areas and will help the Ministry of Health to scale up for implementation of Prevention of Mother-To- Child Transmission of HIV/AIDS as well as Modeling (PMTCT) services in the state and other areas in the country and this will help to improve on the targets. The findings will also provide up-to date information for academicians and could be used as a basis for further research in issues concerning PMTCT since it is a new intervention in the country.


1.6 Scope and Limitation of the Study

This study is primary concerned with prevalence of HIV among This study/project work covers prevalence of HIV among pregnant women attending antenatal. The researcher encountered some constraints, which limited the scope of the study. These constraints include but are not limited to the following

a) Availability of Research Material:

The research material available to the researcher is insufficient, thereby limiting the study

b) Time:

The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.


1.7 Definition of Terms

Prevalence:

Prevalence is a statistical concept referring to the number of cases of a disease that are present in a particular population at a given time, whereas incidence refers to the number of new cases that develop in a given period of time.

Antenatal:

Relating to the medical care given to pregnant women before their babies are born


1.8 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows

  • Chapter one is concerned with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
  • Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
  • Chapter three deals on the research design and methodology adopted in the study.
  • Chapter four concentrate on the data collection and analysis and presentation of finding.
  • Chapter five gives summary, conclusion, and recommendations made of the study

Chapter Five


Summary, Conclusion and Recommendation

5.1 Introduction

It is important to ascertain that the objective of this study was to ascertain a critical analysis of prevalence of HIV among pregnant women attending antenatal.

In the preceding chapter, the relevant data collected for this study were presented, critically analyzed and appropriate interpretation given. In this chapter, certain recommendations are made, which in the opinion of the researcher will be of benefit in addressing the challenges of HIV pandemic in Nigeria


5.2 Summary

This study aimed at havinga critical analysis of prevalence of HIV among pregnant women attending antenatal. Four objectives were raised. These objectives include: To determine and compare knowledge of pregnant women regarding PMTCT the FCT, to determine and compare attitudes of pregnant women regarding PMTCT in the FCT, to determine and compare practice of PMTCT among pregnant women in the FCT, to identify factors that influenced Knowledge, Attitude and Practice of PMTCT among pregnant women in the FCT.


5.3 Conclusion

Based on the above findings pertaining to the objectives of the study the following conclusions are drawn.

The study revealed that HIV prevalence rate amongst women attending antenatal has reduced to a great extent, as compared to what was obtained in previous year. There were significant difference in good knowledge of HIV, ways it can be transmitted, conditions of positive mothers that promote MTCT, conditions in infant that promote acquiring HIV and how MTCT can be prevented between the groups.

It was also observed that there were concerns regarding disclosure of one’s status and that these include fear of reappraisals from the partner’s reaction.


5.4 Recommendation

Much as there are those mothers and people in the FCT who really know about the details of HIV program and services, a big number still do not know the program benefits in details. Therefore, measures should be put in place to make sure the correct and detailed information reaches the community. There is need to create partnership between Ministry of Health and other NGOs so that some programs are harmonized to benefit the community and the target population. The Government should implement the PMTCT Plus (option B plus) as recommended in the 2013 WHO consolidated guidelines for treating and preventing HIV infection so that the partner and other family members can access HIV prevention, care and support services. There is need to carry out an In-depth investigation on mothers enrolled for PMTCT program so that their experiences are documented and shared. This will help the program implementers ensure quality services without stigmatizing the clients. HIV and PMTCT interventions should include public awareness, education and campaigns that target the general population including child bearing age women especially in rural areas. Health workers at the antenatal clinics should educate mothers on the services that are offered with regards to PMTCT of HIV and also provide information of the benefits of the services in order to assist pregnant women to make informed decisions.


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