Determinants of loss to follow up HIV exposed infants in Lusaka, Zambia.
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Date
2022
Authors
Chemba, Ruth
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Introduction - Prevention of Mother-To-Child-Transmission (PMTCT) programmes aimed at preventing vertical transmission have been widely implemented in Zambia by the Ministry of Health (MoH). However, many infants are not benefitting from the programmes due to loss to follow up (LTFU) at different points of the PMTCT cascade, with the highest loss occurring at 18 months. This compromises the effectiveness of PMTCT services. The aim of this study was to establish determinants of LTFU infants born to HIV positive women in Lusaka district.
Methodology - A descriptive cross sectional study design using a quantitative approach was conducted in three Lusaka Urban District Clinics. The sample size comprised of 160 caretakers of LTFU infants and 25 health care providers. Data from caretakers were collected using a semi-structured questionnaire while that from healthcare workers were through a self-administered semi-structured questionnaire. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22.0 and presented using frequency tables, bar charts, and cross tabulations. Logistic regression was used to test associations between the dependent and independent variables. The cut off point for statistical significance was set at 5%. P-values of 0.05 or less were considered statistically significant.
Results - The finding showed that 42.4% caretakers were not aware that they needed to continue with follow up care, while 28.0% stated forgetting taking their infants for follow up care. The results further showed that the association between gender of caretaker [OR 0.252 (1.101-0.633) p-value 0.003], relationship between caretaker and infant [OR 0.592 (0.699-0.189) p-value 0.003], staff attitude [OR 10.012 (4.194-23.947) p-value 0.003], prophylaxis given at birth [OR 0.299 (0.131-0.684) p-value 0.004], and place of birth [OR 2.324 (1.050-5.143) p-value 0.037] and LTFU were statistically significant. Binary logistic regression indicated that association between gender of caretaker [OR 0.4 (CI, 0.287-0.966) p-value-0.040], negative staff attitude [OR-2.7 (1.050-5.114) p-valu-0.047] and waiting time [OR 0.7 (CI-0.314-5.665) p-value-0.003] and LTFU were also statistically significant.
Conclusion - The results suggest that change in staff attitude and improvement in waiting time can reduce chances of loss to follow up care. Therefore, the study recommends that clinics should come up with an easy appointment scheduling process to help reduce waiting time for follow up care clients; such as providing a specific appointment time.
Description
Thesis of Master of Science in Midwifery, and Women Health