Reasons For Default From Prevention Of Mother To Child Transmissions (pmtct) Of Hiv Program In Addis Ababa

Back Ground: As of February 2004 Prevention of Mother to childrntransmission of HIV program was started as “hareg” project at five healthrnfacilities in Addis Ababa which later expanded to 33 sites. Since itsrnstarts, yearly regional health bureau report showed that the region didn`trnachieved the national Prevention of Mother to child transmission of HIVrnprogram target in relation to counseling and test acceptance. More everrnless than half of HIV positive mothers and their infant have taken fullrncourse of Nevirapin while the other half default from Prevention ofrnMother to child transmission of HIV program and they didn`t takernNevirapin.rnObjective: the main objective of the study is to identify reasons of HIVrnpositive women for defaulting from PMTCT program and not taking ARVrnprophylaxis in Addis Ababa after they receive their post test HIV result.rnMethods: Prevention of Mother to child transmission of HIV programrnuptake analysis was done among ANC attendants for Prevention ofrnMother to child transmission of HIV –Voluntary counseling and testingrnuptake and on the uptake for Nevirapin for all Prevention of Mother tornchild transmission of HIV mothers and their newborns during two yearsrnof Prevention of Mother to child transmission of HIV programrnimplementation at “Hareg” pilot sites by reviewing national registration,rnrecording and reporting formats. Qualitative study through in depthrninterview with HIV positive mothers who lost from PMTCT program andrnfocus group discussion with health professional working at PMTCT clinicrnand mother to mother support group were conducted to investigate thernwomen`s reasons for not accepting ARV prophylaxis in PMTCT programrnin Addis Ababa at “Hareg” PMTCT pilot sites. Collected data wererntranslated, transcribed, prepared in Microsoft word document which isrnchanged to plain text. The document imported to Open code soft ware,rnand coding, listing of frequencies, and data reduction were done. Therndata then summarized. Interpretations of data, drawing of conclusionrnwere performed.rnResult:- Total of 95378 new antenatal care attendants were registeredrnduring this two-year period, of whom 44095 (46%) enrolled for VCT at thernPMTCT program and 28635 (65 %) tested for HIV. Three thousands fourrnhundreds and eighteen (3418) (11.9%)mothers tested HIV positive andrnwere therefore enrolled in the PMTCT program. However, only 1913 (56%)rnHIV positive pregnant mothers received the Nevirapine during delivery.rnMoreover: only 1965(57%) newborns received Nevirapine within 72 hoursrnafter birth showing close to half of mother`s lost to follow up and didn`trnreceive Nevirapin. Quality of health care during PMTCT counseling, followrnup, and delivery, stigma and discrimination were identified as the mainrnreasons for loose from PMTCT follow up and not took ARV prophylaxisrnduring delivery. Additional reasons mentioned includes personal factorsrnassociated with the clients including religion related factors, distancernfrom facilities, changing of place and disclosure.rnConclusion and recommendation Strengthening monitoring andrnEvaluation of PMTCT programs, mothers to mothers support group,rncommunity mobilization, quality assurance program in PMTCT,rnnutritional support and involvement of families in PMTCT program wouldrnhave paramount benefit in increasing ARV prophylaxis uptake.rnKey words: PMTCT, ARV prophylaxis, Mother to mother , Nevirapin

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