Male partner involvement in pmtct
Therefore, to save lives of mothers and their newborn from acquiring HIV, male partners should do their maximum endeavor regardless of any determinant factors as our results revealed its status in our study context and elsewhere at past time too. Mother-to-child transmission is the most common mode of human immunodeficiency virus HIV transmission in children which can be vertically transmitted from HIV positive pregnant women to their unborn babies during pregnancy, labour, and delivery or through breastfeeding after delivery [ 1 — 3 ]. HIV remains a major challenge globally regardless of decades of advocacy and investment in programs to control the spread of the virus [ 4 , 5 ]. Globally, an estimated The number of newly infected children in was , in low- and middle-income countries [ 7 ].SEE VIDEO BY TOPIC: Pt.2: HIV/AIDS: Understanding Prevention of Mother-to-Child Transmission (option B+)
SEE VIDEO BY TOPIC: HIV Stigma From Doctors and NursesContent:
Role of male partners in the prevention of mother-to-child HIV transmission
Box , Dar es salaam. Globally, there are 3. A cross sectional study involving selected health facilities was conducted in Mwanza urban from October through January HIV positive pregnant women attending ante-natal clinic ANC were interviewed using a semi structured questionnaire. Univariate analysis was used to describe the study respondents where bivariate and logistic regression was used to determine predictors of male involvement. Few mothers Mothers who never wanted to be escorted by their male partners and busy partners were associated with reduced odds of male involvement into PMTCT AOR 0.
Busy male partners and mothers who did not want to be escorted by their partners were a hindrance to male involvement in PMTCT services. HIV and AIDS continue to be a major public health problem where almost 70 million people have been infected with the Human Immune deficiency Virus and about 35 million people have died of AIDS since the beginning of the epidemic [ 1 ]. Success in preventing MTCT will not only depend on use of antiretroviral prophylaxis, but also on continuing support to the nursing mothers from their male partners.
Mechanism by which male involvement contributes to the effectiveness of PMTCT include male socio cultural superiority and influence in many of the Africa settings [ 8 ]. Women learn and retain more information when educated together with their partners [ 9 ] and some pregnant mothers don't accept HIV testing till they have their partners consent or assent [ 10 ].
Indeed utilization of PMTCT services by pregnant women is affected by several factors such as fear of disclosure of HIV results, lack of male partner support, fear of violence, abandonment and stigmatization which all involve a male partner. Male involvement facilitates both ART initiation and adherence [ 11 , 12 ], it increases the probability of mothers delivering at health facility [ 13 ] and it enables for a good choice of breastfeeding plan [ 14 — 16 ].
This study aimed in determining magnitude, predictors as perceived by pregnant mothers and effects of male partner involvement in PMTCT services. This was hospital based cross sectional study involving HIV positive pregnant women in Mwanza urban conducted from October through January Mwanza urban has a population of , people where , are women in reproductive age group of 15 to 49 years [ 17 , 18 ].
Ten out of 45 Health facilities in Mwanza urban were selected by simple random sampling using lottery method.
Proportional to size sampling technique was used to obtain the number of study participants from each participating health facility The size of each facility was the number of PMTCT attendees as per quarter of July-September Therefore the total sample size was estimated at HIV positive pregnant women. A pregnant mother in first or second trimester or if her partner is not alive was excluded from the study.
Eligible clients from each Health facility who attended on days of interview were enrolled sequentially into the study. A face to face interview was conducted using a pre tested, semi structured questionnaire to collect information on socio demographic information both for participants and their male partners, partner testing and providing support to the mother and Factors affecting male participation in various PMTCT services as perceived by the mothers.
Information on mother disclosure of HIV test result to her partner and any negative consequences after disclosure was also obtained. Data were entered, cleaned, analyzed using Epi info version 3. Partner aware of mother's HIV status disclosure was further evaluated for existence of any form of Gender Based Violence. All independent variables including partner's knowledge were factors perceived by the mother as the respondent.
Marital status such cohabiting and married were codes as living together while single and divorce were coded as not living together. Further coding for marital status was married for married couple while cohabiting, divorce and single were coded as not married. Univariate and Bivariate were done. Step down procedure for logistic regression was used to identify variables associated with male partner involvement in the final model.
At the local level permission was also sought from Mwanza region authority and the respective health facilities authority. A written consent was obtained from each participant before interview. A total of HIV positive pregnant mothers were interviewed in this study. The mean age of the respondents was Majority, Median gravidity was three with Inter-quartile range IQR of two and four while the median number of living children was two with IQR of one and three.
The overall male partner involvement in PMTCT services include men who scored yes in all the three questions was Beating alone was the second most common form of abuse Figure 1. Socio-demographic factors of both mother and partner such as marital status, partner being in same religion, polygamist partner and partner's level of education were also assessed.
In additional mothers who live together with their male partners are three times more likely to have their male partners involved in PMTCT services than those who don't live together COR 3. Also mothers who reported to be in same religion with their partners had six times increased chances of male partner being involved in PMTCT services than those who were not in the same religion COR 5. On logistic regression, proactive mothers who always ask for escort from their partners ranked the first as a promoting factor for male involvement in PMTCT services.
Data show that mothers who always ask for escort from their partners had The rest factors which were significant on Bivariate analysis were not significant on logistic regression model Table 3. In this study we aimed also at determining the effect of male partner involvement on reported gender based violence.
This study was able to determine magnitude of male partner involvement into PMTCT services as well as identifying factors affecting male partner involvement into PMTCT services as perceived by mothers. Furthermore it has demonstrated that male partner involvement has a significant influence on preventing Gender based violence.
The magnitude of male partner involvement shown in this study was However due to differences in definition of male involvement and setting of the study, the magnitude in this study is much higher from In the same way as found by Kilewo C.
Tadesse E et al in Blantyre Malawi found also that women have great trust to their male partners if and only if they are tested for HIV because majority of them choose their partner as their primary confidants after they tested for HIV [ 28 ].
In this study, it has been shown that women have a great role to play in making their male partners involved into PMTCT. Data show that proactive mothers who always ask their partners for escort to ANC are mostly associated with positive impact on male partner involvement. The studies done by Fisaha H et al in Makelle, Nothern Ethiopia on male partner involvement in PMTCT also found that maternal willingness to inform their husband about availability of testing services at ANC was an independent predictor for male partner involvement [ 29 ].
Many studies have found that lacking PMTCT knowledge among male partners is a major hindrance to their male involvement [ 29 , 30 ]. On the other hand factors such as socio cultural norms, polygamist partner, and perceived ANC distance which have been shown by other studies as determinants of male involvement in PMTCT [ 23 , 31 , 32 ] were not found to be significant in this study.
This is likely to be due to changes in taboos favored by technological advancement in information sharing. Many people in urban area own TV, Radio and phones which have access to various communication media such as facebook, whats up, twitter to mention a few.
People can acquire knew knowledge easily and fast, and this facilitates changes in taboos. Factors like friendly ANC services and partner fearing of HIV test result were inconclusively significant because of having empty numbers in some of the shells. This could require more exploration with large sample size. Likewise, a study done by Semrau K et al in reported that couple counselling makes a man more responsible for the health of the partner and the family resulting to less blame and discrimination [ 33 ].
This indicates that counselling and HIV status disclosure resulting from male involvement reduce the probability for a male to engage in violence. Despite that to a large extent this study has been able to answer intended research questions also it has some limitations. First in this study male information was extracted using female partner.
A use of this approach in one way or another might affect the result in this study because female partner is more likely to have recall bias however the findings of this study correlate with other studies which interviewed men [ 20 , 30 ].
Second the possibility of desirability bias is also expected because mothers attending PMTCT services are trained on PMTCT hence they tend to answer what they think is expected from them.
Thirdly, the cross section nature of this study will not prove if the associated factors of male involvement are actually causal. However, most factors identified are also supported by robust studies done elsewhere.
Fourth, we anticipated that the use of pre-prepare structure questionnaire may results into information bias, to minimizes this all interviewers were oriented to the meaning and intention of every question before beginning the study.
Finally this study was done into a single selected region in Tanzania this might limit generalizability of its findings. This study was set out to demonstrate the magnitude of male partner involvement and measure the strength of association with the determinants. Unwillingness of a mother to be escorted by partner is the major hindrance of male involvement into PMTCT services. Male partner involvement is likely to reduce events of gender based violence.
Unwillingness of a mother to be escorted by partner is the major hindrance of male involvement into PMTCT services;. We would like to sincerely thank Steve Wiersma for his invaluable supervision of this work since inception of the study through data collection and revision the manuscript.
Further gratitude goes to Mwanza Authorities for allowing us conduct this study in their health facilities without forgetting the interviewees who consented and collaborated in the study.
ME conceptualized the study, collected the data, did initial analysis and drafting the manuscript. EJM conceptualized the study, supervised data collection, revised and interpreted the data analysis and revised the manuscript. All authors have read and approved the final draft of the manuscript.
National Center for Biotechnology Information , U. Pan Afr Med J. Published online Jun 6. Author information Article notes Copyright and License information Disclaimer.
Received Jan 19; Accepted May This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Introduction Globally, there are 3. Methods A cross sectional study involving selected health facilities was conducted in Mwanza urban from October through January Methods This was hospital based cross sectional study involving HIV positive pregnant women in Mwanza urban conducted from October through January Results Socio demographic information A total of HIV positive pregnant mothers were interviewed in this study.
Open in a separate window. Figure 1. Effect of male partner involvement on domestic partner violence In this study we aimed also at determining the effect of male partner involvement on reported gender based violence.
Discussion This study was able to determine magnitude of male partner involvement into PMTCT services as well as identifying factors affecting male partner involvement into PMTCT services as perceived by mothers. Conclusion This study was set out to demonstrate the magnitude of male partner involvement and measure the strength of association with the determinants. Competing interests The authors declare no competing interest.
Besada, D. Rohde, S. Global Health Action November , 7 9 : , e-publication ahead of print. A mixed-skill team of 34 researchers conducted desk reviews and in-country field work; and held key informant interviews and focus group discussions with stakeholders including government, implementing partners, and district-, facility-, and community-based health workers.
Metrics details. This study therefore set out to explore the meaning of male partner involvement and propose a definition and theoretical model of this concept in PMTCT in Uganda. Eight focus group discussions and five in-depth interviews were conducted with couples at three public health facilities and community members in the health facility catchment areas in Uganda. The study employed a grounded theory approach underpinned by the pragmatic philosophical paradigm. Data were analyzed using the constant comparative method, performing three levels of open, axial, and selective coding.
Metrics details. Infant antiretroviral prophylaxis plays an important role towards ensuring the reduction of HIV transmission from mother to child in the postpartum period. We conducted a systematic review and meta-analysis to determine the impact of male partner involvement approaches on the uptake of infant antiretroviral prophylaxis in SSA. Only studies carried out in SSA that reported an approach used in involving male partners and the impact on the uptake of infant antiretroviral prophylaxis irrespective of the Language and date of publication were included. Odds ratios were extracted or calculated from studies and combined in a meta-analysis using the statistical package Stata version Forest plots were generated using the random effect model. From an initial non-duplicate articles, 09 articles were included in the systematic review and meta-analysis. The pooled unadjusted odds ratio was 2.
Male involvement, the authors add, may be an underutilised public health intervention to address both infant HIV infection and mortality in resource-poor settings. Transmission of an infection from mother-to-baby, during pregnancy, childbirth, or breastfeeding. The result of a statistical test which tells us whether the results of a study are likely to be due to chance and would not be confirmed if the study was repeated. All p-values are between 0 and 1; the most reliable studies have p-values very close to 0. A p-value of 0.
Box , Dar es salaam. Globally, there are 3. A cross sectional study involving selected health facilities was conducted in Mwanza urban from October through January HIV positive pregnant women attending ante-natal clinic ANC were interviewed using a semi structured questionnaire. Univariate analysis was used to describe the study respondents where bivariate and logistic regression was used to determine predictors of male involvement.
Ее секрет был спрятан в керамических шахтах, уходивших на шесть этажей вниз; ее похожий на ракету корпус окружал лабиринт подвесных лесов и кабелей, из-под которых слышалось шипение фреоновой системы охлаждения.
Генераторы внизу производили постоянный низкочастотный гул, что делало акустику в шифровалке какой-то загробной, присущей миру призраков. ТРАНСТЕКСТ, подобно всем великим технологическим достижениям, появился на свет в силу необходимости. В 1980-е годы АНБ стало свидетелем революции в сфере телекоммуникаций, которой было суждено навсегда изменить весь мир разведывательной деятельности, - имеется в виду широкая доступность Интернета, а если говорить конкретнее - появление электронной почты.
Преступники, террористы и шпионы, которым надоело прослушивание их телефонов, с радостью встретили это новое средство глобальной коммуникации. Электронная почта соединила безопасность обычной почты со скоростью телефонной связи.
Забыла. - Там проблема с электричеством. - Я не электрик. Позвони в технический отдел. - В куполе нет света.
А теперь выходи. Но Мидж эта ситуация явно доставляла удовольствие. Она подошла к окну, вертя бумагу перед глазами, чтобы найти лучший угол для падения лунного света. - Мидж… пошли.
Прочитаешь за дверью. А теперь выходи. Но Мидж эта ситуация явно доставляла удовольствие.
Ключ, как правило, был довольно длинным и сложным и содержал всю необходимую информацию об алгоритме кодирования, задействуя математические операции, необходимые для воссоздания исходного текста. Теперь пользователь мог посылать конфиденциальные сообщения: ведь если даже его послание перехватывалось, расшифровать его могли лишь те, кто знал ключ-пароль.
Бринкерхофф терпеливо ждал, пока она изучала цифры. - Хм-м, - наконец произнесла. - Вчерашняя статистика безукоризненна: вскрыто двести тридцать семь кодов, средняя стоимость - восемьсот семьдесят четыре доллара. Среднее время, потраченное на один шифр, - чуть более шести минут.
Потребление энергии на среднем уровне.
Люди на подиуме не отрываясь смотрели на экран. Агент Смит начал доклад. - По вашему приказу, директор, - говорил он, - мы провели в Севилье два дня, выслеживая мистера Энсея Танкадо. - Расскажите, как он погиб, - нетерпеливо сказал Фонтейн. Смит сообщил: - Мы вели наблюдение из мини-автобуса с расстояния метров в пятьдесят.
Труп надо передвинуть. Стратмор медленно приближался к застывшему в гротескной лозе телу, не сводя с него глаз. Он схватил убитого за запястье; кожа была похожа на обгоревший пенопласт, тело полностью обезвожено. Коммандер зажмурился, сильнее сжал запястье и потянул.