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Preventing HIV in newborns and infants: the experience of Tanzanian mothers

预防新生儿和婴儿感染艾滋病毒：坦桑尼亚母亲的经验

基本信息

批准号：
8727099
负责人：
Shannon McMahon
金额：
$ 2.49万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2014-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8727099
关键词：
AIDS prevention AIDS/HIV problem Address Adherence Affect Africa South of the Sahara Age Age-Years Anti-Retroviral Agents Area Attitude Behavior Behavioral Birth Breast Feeding Caring Child Child health care Clinic Clinical Collaborations Counseling Country Data Data Collection Decision Making Drops Effectiveness Enrollment Epidemic Evaluation Event Face Goals Government HIV HIV Infections HIV Seropositivity Health Health Personnel Health Policy Health Status Health care facility Health system Home environment Hospitals Individual Intention Intervention Interview Knowledge Letters Life Low income Mentors Methods Modeling Mothers Nature Newborn Infant Nurses Outcome Pathway interactions Patients Performance Pharmaceutical Preparations Physicians Policies Policy Maker Population Study Postpartum Period Pregnancy Pregnant Women Prevention Process Professional counselor Prophylactic treatment Provider Publishing Qualitative Research Reporting Reproductive Health Research Research Personnel Research Training Resources Respondent Risk Role Rural Sample Size Sampling Services Social Welfare System Tanzania Testing Time Translating UNICEF Vertical Disease Transmission Woman Work base cost evidence based guidelines experience falls follow-up improved instrument intimate behavior postnatal prevent programs social social cognitive theory tool transmission process uptake virtual

项目摘要

DESCRIPTION (provided by applicant): Aims: This study will explore issues related to uptake of and adherence to interventions addressing the prevention of mother-to-child transmission of HIV in rural Tanzania. The study will examine how social and behavioral factors affect testing, counseling and treatment for HIV and PMTCT among pregnant women and recently-delivered mothers. This study will also investigate how clinical officers (such as nurses) and policy makers (such as district, regional and national health officials) view their role in providing PMTCT at th health facility-level, specifically the barriers or facilitating factors they face to providing effctive services or devising effective policies to help mothers. Ultimately, this research aims to provide stakeholders who are engaging in PTMCT interventions or policies with evidence on how to improve programs in a manner that is culturally acceptable and feasible in this context. Background: Although there has been an increased coverage of PMTCT programs globally, there are still many unresolved barriers to the program. In sub-Saharan Africa, cumulative losses to follow up in PMTCT programs range from 28% during antenatal care, up to 70% four months after delivery and close to 81% by six months post-partum. In southern Tanzania, a country that is among the hardest hit by the HIV/AIDS epidemic, there have been no published studies qualitatively investigating barriers to or facilitating factors in accessing PMTCT. The author of this study seeks to build on her previous research on careseeking among pregnant women and recently-delivered mothers in Tanzania by qualitatively exploring this issue. Findings from this study as well as all related instruments will be shared with stakeholders including policy makers and PMTCT implementers, with the intention of not only sharing findings but also sharing tools that may prove useful for data collection in similar settings. Methods: The study population will be based in Morogoro, Tanzania. In-depth interviews will take place with at least 10 health facility staff who provide PMTCT services, at least 10 policy makers who engage in PMTCT programming and implementation and at least 30 pregnant women or mothers, who are HIV-positive, between 18 and 35 years of age, and attended ante-natal care at the Morogoro Regional Hospital. The study will draw from quantitative knowledge gathered by the primary mentor of this proposal, but will be qualitative in nature and informed by Social Cognitive Theory and the Social-Ecological Model. The sampling strategy for interviewing mothers will involve coordination with physicians, home-based care providers and research staff to purposively identify a group of PMTCT patients. The sampling strategy for interviewing clinic staff and governmental officials will also be purposive, with an emphasis on identifying individuals who engage in provision of PMTCT services, namely individuals working within the Reproductive and Child Health Units of clinics and government offices.

描述（由申请人提供）：目的：本研究将探讨与坦桑尼亚农村预防艾滋病毒母婴传播的干预措施的吸收和坚持有关的问题。这项研究将探讨社会和行为因素如何影响孕妇和刚分娩的母亲对艾滋病毒和预防母婴传播的检测、咨询和治疗。本研究还将调查临床官员（如护士）和政策制定者（如地区，区域和国家卫生官员）如何看待他们在卫生机构一级提供预防母婴传播的作用，特别是他们在提供有效服务或制定有效政策以帮助母亲方面面临的障碍或促进因素。最终，本研究旨在为参与PTMCT干预措施或政策的利益相关者提供有关如何以文化上可接受和可行的方式改进方案的证据。背景：尽管全球预防母婴传播方案的覆盖面有所扩大，但该方案仍存在许多未解决的障碍。在撒哈拉以南非洲，预防母婴传播方案的累计失访率从产前护理期间的28%到分娩后四个月的70%，再到产后六个月的近81%。在坦桑尼亚南部，这个受艾滋病毒/艾滋病流行病影响最严重的国家之一，还没有发表研究报告，对获得预防母婴传播的障碍或促进因素进行定性调查。本研究的作者试图建立在她以前的研究careseeking在坦桑尼亚的孕妇和最近交付的母亲定性探讨这个问题。将与包括决策者和防止母婴传播执行者在内的利益攸关方分享这项研究的结果以及所有相关工具，目的不仅是分享结果，而且是分享可能对类似情况下的数据收集有用的工具。方法：研究人群将位于坦桑尼亚的莫罗戈罗。将与至少10名提供防止母婴传播服务的保健设施工作人员、至少10名参与防止母婴传播方案规划和执行的决策者以及至少30名年龄在18至35岁之间、艾滋病毒呈阳性并在莫罗戈罗地区医院接受产前护理的孕妇或母亲进行深入访谈。这项研究将借鉴本提案的主要导师收集的定量知识，但本质上将是定性的，并由社会认知理论和社会生态模型提供信息。采访母亲的抽样策略将涉及与医生、家庭护理提供者和研究人员的协调，以便有目的地确定一组预防母婴传播患者。对诊所工作人员和政府官员进行访谈的抽样战略也将是有目的的，重点是查明从事提供防止母婴传播服务的个人，即在诊所和政府办公室生殖和儿童健康股工作的个人。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

"Tell Me What You Don't Remember": Care-Seeking Facilitators and Barriers in the Decade Following Repetitive Blast Exposure Among Army Combat Veterans.

“告诉我你不记得的事情”：陆军退伍军人重复遭受爆炸袭击后十年内寻求护理的促进者和障碍。

DOI：
10.7205/milmed-d-14-00471
发表时间：
2016
期刊：
Military medicine
影响因子：
1.2
作者：
Chase,RachelP;McMahon,ShannonA;Winch,PeterJ
通讯作者：
Winch,PeterJ

Stigma, Facility Constraints, and Personal Disbelief: Why Women Disengage from HIV Care During and After Pregnancy in Morogoro Region, Tanzania.

DOI：
10.1007/s10461-016-1505-8
发表时间：
2017-01
期刊：
AIDS AND BEHAVIOR
影响因子：
4.4
作者：
McMahon, Shannon A.;Kennedy, Caitlin E.;Winch, Peter J.;Kombe, Miriam;Killewo, Japhet;Kilewo, Charles
通讯作者：
Kilewo, Charles

Sources of community health worker motivation: a qualitative study in Morogoro Region, Tanzania.

DOI：
10.1186/1478-4491-11-52
发表时间：
2013-10-10
期刊：
Human resources for health
影响因子：
4.5
作者：
Greenspan JA;McMahon SA;Chebet JJ;Mpunga M;Urassa DP;Winch PJ
通讯作者：
Winch PJ

Poverty, partner discord, and divergent accounts; a mixed methods account of births before arrival to health facilities in Morogoro Region, Tanzania.

DOI：
10.1186/s12884-016-1058-x
发表时间：
2016-09-27
期刊：
BMC pregnancy and childbirth
影响因子：
3.1
作者：
McMahon SA;Chase RP;Winch PJ;Chebet JJ;Besana GVR;Mosha I;Sheweji Z;Kennedy CE
通讯作者：
Kennedy CE

Systematic debriefing after qualitative encounters: an essential analysis step in applied qualitative research.