Abstract
The study was to evaluate the PMTCT of HIV and AIDS programme in Umuahia hospitals. The study evaluated the availability of PMTCT service, availability and adequacy of qualified service providers and materials, the level of utilization of PMTCT services and factors that influenced the utilization of PMTCT service. The factors evaluated in relation to the utilization of the services were educational level, location and age of HIV positive pregnant women. To achieve the purpose of the study, eleven research questions were posed and four null hypotheses were postulated. The study adopted a cross sectional survey research design. It covered the only PMTCT site (FMC Umuahia) and 5 private hospitals providing VC. All the HIV positive pregnant women that attended ANC at the period of study (4 weeks) were used. All the 14 PMTCT service providers in FMC Umuahia and the 8 PMTCT trained staff in 5 private hospitals were also used as respondents. Data collected were both quantitative and qualitative. Fifty eight HIV positive pregnant women who attended ANC at the period of study responded to the questionnaire for HIV positive pregnant women (QHPPW) while 22 PMTCT service providers responded to the questionnaire for PMTCT service providers (QPSPs). Seven PMTCT service providers were also the participants of the focus group discussion. For the purpose of reaching a valid conclusion, data from the 58 respondents who completed the QHPPH and 22 respondents who completed the QPSPs were analyzed quantitatively. Frequency distribution and percentages were used to answer research questions one and seven, while mean and standard deviation were used to answer research questions two to six. T-test and ANOVA were used to verify the three null hypotheses formulated for the study at 05 level of significance. Data generated from the FGD with PMTCT service providers were used to substantiate the findings. The study revealed that voluntary counseling, HIV testing, antiretroviral therapy, caesarean section and safer infant feeding counseling services were available in the government hospital. Majority of the PMTCT service providers and materials were moderately available and adequate. Four out of the five PMTCT services available were highly utilized by the clients. The study also revealed that majority of the respondents indicated that majority of the factors influenced the utilization of these services. The study further revealed that the utilization of these PMTCT services did not differ by level of education, location and age of clients except the use safer infant feeding counseling which differed based on the location of the clients. Based on the major findings and conclusions, it was recommended among others that Social workers and Health Educators should be employed and trained for PMTCT programme to sensitize, educate and encourage HIV positive pregnant women to avail themselves of PMTCT programme. To educate and encourage rural women who are HIV positive to strictly practice safer infant feeding after delivery.
CHAPTER ONE
Introduction
Background to the Study
 Everyday, approximately 5,000 women are newly infected with HIV (Human Immunodeficiency Virus), and more than 3,000 die from AIDS (Acquired Immune Deficiency Syndrome) – related illnesses (UNAIDS, 2000a). In most parts of the world, HIV infection is increasing faster among women than men. Nowhere is the trend more apparent than in sub – Saharan Africa where women comprise 58 per cent of existing HIV infection (UNAIDS, 2000b). These differences in infection rates are due to a combination of factors. Women and girls are commonly discriminated against in terms of access to education, employment and land inheritance. With increasing poverty levels, African women have found themselves in casual relationship with men as this can serve as a conduit for financial and social security. Women, therefore, find it difficult to demand for safe sex, as they become subordinates or dependents of mainly older men. Women are also biologically prone to infection and HIV is easily transmitted from men to women than the reverse. This has led to the increase in women living with HIV. Results of initial early studies analyzing progression and survival in HIV syndrome suggested a difference based on gender. Most of these studies indicated that the prognosis for women was worse than for men. This reflected late access to limited care (Bastian, Bennet, Adams, Waskin, Divine & Edlin, 1993; Melnick, Sherer, Louise, Hillman, Rodriguez, Lackman, Capps, Brown, Caryln & Korvick 1994). Lack of access to care, minimal self – motivation, and attention to the health care of their children over that of themselves all contributed to decreased rates of early detection and intervention. HIV and AIDS for women, therefore, is an issue of access to health care (UNAIDS, 2003). Furthermore, at the end of 2004, UNAIDS reported that women made up almost half of the 37.2 million adults (aged 15 to 49) living with HIV and AIDS worldwide. The hardest-hit regions are areas where heterosexual contact is the primary mode of transmission. This is most evident in sub-Saharan Africa, where close to 60 per cent of adults living with HIV and AIDS are women. Women and girls make up a growing proportion of those infected by HIV and AIDS (UNAIDS/WHO, 2005a). AIDS is a disease of the immune system that makes the individual highly vulnerable to life-threatening infections such as tuberculosis (TB) and certain types of cancer. AIDS is caused by a retrovirus known as Human Immunodeficiency Virus (HIV) which attacks and impairs the body’s natural defence system against diseases and infections (Piwoz & Preble, 2000). They further stated that HIV is a slow-acting virus that may take years to produce illness in a person. HIV is transmitted via three primary routes: having unprotected sex with a person already carrying the HIV virus; transfusions of contaminated blood and its by-products or use off non-sterilized instruments, such as shared needles, razor, and other surgical tools; and from an infected mother to her child (MTCT) during pregnancy, labour, childbirth or breastfeeding.
