The Institute of Public Health and Management

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Browsing The Institute of Public Health and Management by Author "Achebet, Sylvia"

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    Early Infant Diagnosis of HIV and the Associated Factors Among Children Born to HIV Positive Mothers in Kapchorwa District
    (International Health Sciences University, 2013-09) Achebet, Sylvia
    Background: Based on the most recent global estimates, 2.3 million children younger than 15 years of age are living with HIV, (UNAIDS, 2010) and in line with this, mother to child transmission of HIV results in approx. 370,000 infant infections worldwide each year, (UNAIDS/UNICEF/WHO, 2011). Many countries are moving towards national coverage of services for eMTCT; however most children born to women who are HIV positive are not being systematically monitored and followed up during the post partum period. Main objective: To establish the factors associated with EID of HIV among the children born to HIV positive mothers in Kapchorwa district. Methodology: A total of 130 respondents who had at least an exposed child and were attending HIV care services were interviewed face to face after consent. This was conducted in Kapchorwa district in three health facilities that are offering ART and EID of HIV services. Every respondent was assessed for eligibility using the stipulated criteria for example whether the exposed child was within the age bracket of 6 weeks to 18 months. A researcher administered questionnaire was the data collection tool that had mostly closed ended questions. Univariate and bivariate analysis was used for statistical analysis. Results: Of the 130 respondents interviewed, majority 79(60.8%) of them were age between 25-35 years and 118(90.8%) were biological mothers of the exposed children. As regards parity, 91(70%) of the respondents had less than 4 children and only one (0.8%) of them was male. More than half of the exposed children 74(56.9%) were aged less than 14 months and 66(50.8%) were male. Among the exposed children, 59(45.4%) of them were tested at six weeks as recommended while more than half (54.6%) had delayed diagnosis. The factors that were found to be significantly associated with EID were linkage (referral) from entry points to EID care points (P-value 0.001) and disclosure of the child’s HIV status (P-value 0.012). Conclusion: The level of Early Infant Diagnosis in this study was slightly higher than the national level figures. Linkage from all entry points to the EID care point and disclosure of the child’s HIV status were found to be significant variables that influenced EID of HIV among the exposed children. Recommendations: Mothers/caregivers must be encouraged to disclose their child’s HIV status to someone they trust so as to enhance the care the child receives. Secondly an appropriate linkage (referral) mechanism should be instituted by each setup designed to offer pediatric HIV care services to minimize lost cases. Every health worker – the new and old should undergo in service training on EID of HIV to enhance service delivery at every entry point. Further inquiry should be done on a large scale for example at a regional level so as to make comparison to generalize the findings to a bigger population therefore this calls for more funding into paediatric HIV interventions.
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    Investigate Factors Affecting Adherence to Iron/Folate Supplementation Among Pregnant Women Aged 20 - 40 Years in Kapchorwa Hospital, 2012.
    (International Health Sciences University., 2012-09) Achebet, Sylvia
    Introduction: The study sought to investigate the factors affecting adherence to IFA among pregnant women aged between 20 and 40 attending ANC at Kapchorwa Hospital. Main objective: To investigate the factors affecting adherence to IFA supplements among pregnant women attending ANC at Kapchorwa Hospital. Methodology: A descriptive cross sectional study using convenient sampling method was used to collect data from 384 pregnant mothers. Qualitative and quantitative data was collected using a questionnaire that had questions on socio-demographic characteristics, predisposing, reinforcing and enabling factors was administered to the eligible mothers. The raw data was entered into epidata and exported into SPSS for analysis. Descriptive, bivariate and multivariate logistic regression statistical analyses were used. Results: Of the 326 pregnant women interviewed, 195/326 (60%) were adherent to IFA supplements. Parity of 4 or less (OR=2.1, CI=1.06-3.70, p=0.02), four or less previous ANC visits (OR=0.31, CI=0.13-0.73, P=0.004) and mothers who had social support (OR=3, CI=1.7-4.78, P<0.001) were significantly associated with adherence to IFA supplements. Conclusion: The overall level of adherence was higher than the national estimates although lower than recommended level. Mothers with low parity of less or equal to 4, four or more previous ANC visits and social support from family members were likely to adhere to IFA supplements among women attending ANC in Kapchorwa Hospital. Recommendations: Continuous sensitization of the mothers on the importance of adherence to IFA coupled with improved nutrition; need for early ANC attendance and at least 4 ANC visits during every pregnancy for continuous monitoring on adherence and follow up; ANC cards should be modified by MOH to enable monitoring of adherence to IFA so that defaulting mothers can be identified and supported accordingly; and health workers should provide the appropriate support to mothers of high parity (more than 4 children) to avoid complacency and improve adherence to IFA.