Assessment of factors associated with retention of HIV exposed infants in early infant diagnosis program in Lilongwe rural: A crosssectional study
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Date
2021-11-09
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Kamuzu University of Health Sciences
Abstract
The type of research study: This is a cross-sectional study to determine factors associated with
retention of infants in the Early Infant Diagnosis program.
The problem: The Malawi Country Operational Plan, strategic summary of March, 2020 indicated
that rigorous analyses of patient level data and partner performance has identified the retention of
clients as the single greatest threat to a sustainable HIV response in Malawi. Data obtained from
some health facilities in Lilongwe District shows low retention rates. In the first quarter of 2021,
the HIV department reported that Nkhoma Hospital had attrition rate of 17% at 12 months into the
EID program and 35% at 24 months, Mitundu had 12% attrition at 12 months and 21% at 24
months, Nathenje had attrition of 15% at 12 months and 22% at 24 months. This study seeks to
assess factors associated with retention in the EID Programme in clinics in Lilongwe rural,
Malawi.
Objectives:
Broad objective
To assess factors associated with retention of HIV exposed infants in the early infant diagnosis
program (EID)in clinics in Lilongwe rural, Malawi.
Specific objectives
1. To determine parents/guardians of HIV exposed infants perceived threats associated with
retention of HIV exposed infants in EID
2. To Identify the perceived benefits associated with retention of HIV exposed infants in EID
3. To determine the social-cultural factors associated with retention of HIV exposed infants
in EID
Methodology
This Cross-sectional study employing a Barrier Analysis approach will be conducted at Nkhoma
Mission Hospital, Ntenthera Health Centre, Nathenje as well as Mitundu Rural Hospital. The study
population will be parents/guardians of HIV exposed infants 0-24 months of age. The sample size
will be 90, 45 doers and 45 non-doers. Doers are those that do the behavior, in this study doers
will be the infants who are consistently retained in the program while non-doers are those that do
not do the behavior, in this study non-doers will be those infants that are loss to follow. Data will
be collected using a pre-designed barrier analysis questionnaire template, the template will be
utilized to develop questions specific for this study. Data will be kept in lockable cabinets. It will
be entered on barrier analysis predesigned data analysis software.
Expected findings and their dissemination
The study expects to find factors that are associated with retention of infant in the EID program.
The factors that promote retention as well as those that derail it will be identified through this
study. It is expected that the study will uncover sociocultural factors, perceived threats as well as
perceived benefits of retaining infants in the EID program. The factors could be socio-economic,
religious, cultural, individual/personal factors, community factors, health facility. Studies have
shown motivating factors to continue in the Programme to be a wish to have a healthy baby while
barriers to be denial of the actual HIV status, lack of disclosure of HIV status, fear of side effects
of the drugs, lack of support, unsynchronized hospital appointments for mother and babies among
other issues. The findings of the study will be shared with Nkhoma Mission Hospital, Lilongwe
District Health Office as well as Kamuzu College of Health Science’s Library. A manuscript will
be developed from the findings which will be submitted to a peer review journal for publication