Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural Malawi
Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural Malawi
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DOI：
10.1016/j.trstmh.2008.04.002
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发表时间：
2008-12-01
影响因子：
2.2
通讯作者：
Schouten, E. J.
中科院分区：
文献类型：
--
作者：
Bwirire, L. D.;Fitzgerald, M.;Schouten, E. J.
这项研究的目的是确定马拉维一家农村地区医院预防母婴艾滋病毒传播（PMTCT）计划中艾滋病毒阳性母亲接受随访的比例较高且逐渐增加的原因。在总共25名产前和产后母亲以及护士助产士（中位年龄39岁，范围22-55岁）中进行了三次焦点小组讨论。拒绝随访的主要原因包括：（1）产前检查前没有做好艾滋病病毒检测及其影响的准备;（2）担心暴露艾滋病病毒感染状况后会受到羞辱、歧视、家庭冲突甚至离婚;（3）缺乏不愿接受艾滋病病毒检测的丈夫的支持;（4）感到不得不依靠人工喂养，这与社会和文化禁忌有关;（5）在产前护理中心等待时间长;（6）无力支付与到医院的长途交通费用。这项研究揭示了一些社区和提供者相关的业务和文化障碍，阻碍了整体接受预防母婴传播，需要迫切解决。需要在社区和保健提供者两级更好地向接受产前服务的母亲提供信息和支助。(c)2008年皇家热带医学和卫生学会。由Elsevier Ltd.出版，版权所有。
This study was conducted to identify reasons for a high and progressive toss to follow-up among HIV-positive mothers within a prevention-of-mother-to-child HIV transmission (PMTCT) program in a rural district hospital in Malawi. Three focus group discussions were conducted among a total of 25 antenatal and post-natal mothers as well as nurse midwives (median age 39 years, range 22-55 years). The main reasons for toss to follow-up included: (1) not being prepared for HIV testing and its implications before the antenatal clinic (ANC) visit; (2) fear of stigma, discrimination, household conflict and even divorce on disclosure of HIV status; (3) lack of support from husbands who do not want to undergo HIV testing; (4) the feeling that one is obliged to rely on artificial feeding, which is associated with social and cultural taboos; (5) long waiting times at the ANC; and (6) inability to afford transport costs related to the long distances to the hospital. This study reveals a number of community- and provider-related operational and cultural barriers hindering the overall acceptability of PMTCT that need to be addressed urgently. Mothers attending antenatal services need to be better informed and supported, at both community and health-provider level. (c) 2008 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. Ail rights reserved.