Prevention of mother-to-child transmission of HIV infection: Views and perceptions about swallowing nevirapine in rural Lilongwe, Malawi

O'Gorman, Deirdre A.; Nyirenda, Lot J.; Theobald, Sally J.
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p354
Academic Journal
Background: In 2006 the World Health Organization described the status of prevention of mother to child transmission (PMTCT) service implementation as unacceptable, with an urgent need for a renewed public health approach to improve access. For PMTCT to be effective it needs to be accessible, acceptable and affordable; however research in Africa into accessibility, uptake and acceptability of PMTCT services has been predominately urban based and usually focusing on women who deliver in hospitals. The importance of involving other community members to strengthen both PMTCT uptake and adherence, and to support women emotionally, has been advocated. Urban men's and rural traditional birth attendants' (TBAs) involvement have improved uptake of HIV testing and of nevirapine. Methods: A qualitative study was carried out in a rural district of Malawi's central region to explore the views about and perceptions of PMTCT antiretroviral treatment. Semi-structured interviews and focus group discussions were held with antenatal and postnatal women, fathers, grandmothers, TBAs, community leaders and PMTCT health workers. Results: Two broad themes of findings emerged: those that relate to the hospital PMTCT service, and those that relate to the community. Trust in the hospital was strong, but distance, transport costs and perceived harsh, threatening health worker attitudes were barriers to access. Grandmothers were perceived to have influence on the management of labour, unlike fathers, but both were suggested as key people to ensure that babies are brought to the hospital for nevirapine syrup. TBAs were seen as powerful, local, and important community members, but some as uneducated. Conclusion: PMTCT was seen as a community issue in which more than the mother alone can be involved. To support access to PMTCT, especially for rural women, there is need for further innovation and implementation research on involving TBAs in some aspects of PMTCT services, and in negotiating with women which community members, if any, they would like to support them in ensuring that newborn babies receive nevirapine.


Related Articles

  • A practice for all seasons: male circumcision and the prevention of HIV transmission. Addanki, Krishna C.; Pace, D. Gene; Bagasra, Omar // Journal of Infection in Developing Countries;2008, Vol. 2 Issue 5, p328 

    HIV/AIDS as a global epidemic has exerted its terrifying influence for quite some time now. Currently, a vaccine for its prevention appears to be near impossible. HIV has spread across the globe without deference to gender, race, religion, or socioeconomic status. Despite a growth in HIV...

  • Harm Reduction and Injection Drug Use: Pragmatic Lessons from a Public Health Model. Reid, Robert J. // Health & Social Work;Aug2002, Vol. 27 Issue 3, p223 

    The article focuses on risks of spread of HIV infection among drug users. The spread of HIV infection among injection drug users (IDUs) is one of the most challenging and tenacious aspects of the drug problem plaguing the U.S. Injection drug use represents a major public health challenge because...

  • The Xchange Point: A Drop-In Center for African American Active Injection Drug Users. MacMaster, Samuel A.; Vail, Kenneth A.; Neff, James Alan // Health & Social Work;Aug2002, Vol. 27 Issue 3, p227 

    The article presents information on the efforts of a organization in AIDS control. Located in Cleveland, Ohio, the Xchange Point is a nonprofit community-based AIDS services organization founded in 1996 as a street-based outreach and SEP. Trained community health outreach workers have conducted...

  • The Global AIDS Situation: WHO Update, January 1988.  // American Journal of Public Health;Apr88, Vol. 78 Issue 4, p410 

    The article reports on the increase in the number of reported cases of AIDS and countries reporting AIDS. The total number of AIDS cases as of January 1, 1988 is estimated to be approximately 150,000. The estimate of the proportion of cases of AIDS acquired through heterosexual contact has...

  • Knowledge of Pregnant Women on Mother-to-Child Transmission of HIV in Yaoundé. Bissek, Anne-Cécile Zoung-Kanyi; Yakana, Irène Emah; Monebenimp, Franscisca; Chaby, Guillaume; Akondeng, Linda; Angwafor, Samuel A.; Lok, Catherine; Njamnshi, Alfred K.; Muna, Walinjom F. T. // Open AIDS Journal;2011, Vol. 5, p25 

    Introduction: Mother-to-child transmission of HIV is a major public health problem in Cameroon. The aim of this study was to assess knowledge of pregnant women on HIV transmission and prevention, particularly the four pillars of mother-to-child transmission. Materials and Methods: This was a...

  • Emancipate CDC. Susser, Mervyn // American Journal of Public Health;Apr93, Vol. 83 Issue 4, p491 

    In this article the author reflects on the political barricades against the control of the human immunodeficiency virus (HIV). He explains that such barriers have frustrated efforts to protect the U.S. population and some of the world's population too against acquired immunodeficiency syndrome....

  • Neurodevelopmental status of HIV-exposed but uninfected children: A pilot study. Springer, P.; Laughton, B.; Tomlinson, M.; Harvey, J.; Esser, M. // South African Journal of Child Health;May2012, Vol. 6 Issue 2, p51 

    Introduction. HIV affects children both directly and indirectly, with evidence of increased infectious mortality and morbidity in the HIV-exposed but uninfected (HEU) infant. There is little published research on neurodevelopmental outcome of HEU infants in Africa. Following the introduction of...

  • HIV/AIDS knowledge in detention in Hunan province, China. Weidong Zhang; Xinya Wang; Xi Chen; Fan Lv // BMC Public Health;2010, Vol. 10 Issue 1, p221 

    Background: Injection drug use (IDU) is one of the major modes of HIV transmission in China. Drug use is illegal in China, all identified drug users are registered by Public Security Bureau, and most were sent to detention; most detainees engaged in high risk behaviours. In order to well...

  • Preventing MTCT of HIV infections still a health priority. Salmon, Kimberley // PharmacoEconomics & Outcomes News;9/11/2004, Issue 461, p3 

    Reports on the result of the longitudinal analysis conducted by researchers from Uganda and the U.S. regarding the cost-effectiveness of a functioning programme in Uganda to prevent mother-to-child transmission of HIV infections. Effect of voluntary counseling and testing component of the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics