HIV/ AIDS

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Browsing HIV/ AIDS by Author "Banda, Lucy Grace"

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    A qualitative study to assess the determinants of and strategies for postpartum HIV-retesting among women who tested HIV negative antenatally in Thyolo district, Malawi, version 1.0
    (Kamuzu University of Health Sciences, 2022-07-05) Banda, Lucy Grace
    Type of research study This a qualitative study to assess the determinants of and strategies for postpartum HIV-retesting among women who tested HIV negative antenatally in Thyolo district, Malawi. The problem In Malawi, Prevention of Mother to Child transmission of HIV (PMTCT) services focus on an opt-out approach where a woman can opt out of a test rather than a mandatory approach. All pregnant women are offered Human Immunodeficiency Virus (HIV) test at their first antenatal care (ANC) visit then a repeat HIV testing at 3 months and during delivery if status is unknown. However, detection of HIV infection in women in late pregnancy or the postpartum period is uncommon as testing practices often focus on testing at the first antenatal visit and postpartum mothers can “opt-out”. The National PMTCT program updates for 2020 reported that 36% of the new HIV infections among children during postpartum and breastfeeding were from mothers who became HIV positive after testing HIV negative during antenatal period. There is currently no Malawi Ministry of health (MOH) policy pertaining postpartum HIV retesting. This study, therefore, aims to assess the factors that influence and strategies that would promote postpartum HIV retesting in women who were HIV negative during the antenatal period. Broad Objective: To assess the determinants of and strategies for HIV retesting among postpartum mothers who had HIV negative status antenatally to reduce mother-to-child transmission of HIV. Specific Objectives  Identify the facilitators for HIV retesting among postpartum mothers with previous negative HIV status.  Explore the barriers to HIV retesting among postpartum mothers with previous negative HIV status.  Assess the health system strategies that can be put in place to scale up the uptake of HIV retest among postpartum mothers.  Outline the strategies that postpartum mothers prefer to increase uptake of the HIV retest.  Describe the strategies that service providers prefer to increase uptake of postpartum HIV retest Methodology The study will use descriptive and ethnographic qualitative approaches. We intend to use multiple data sources to ensure increased data collection hence we will use both Focus group discussions and in depth interviews. Each focus group discussion will comprise 6-12 health workers from various study facilities. About 30 participants will be interviewed among health care workers and postnatal mothers in the selected health facilities in Thyolo. We plan to use 3 health facilities of Thyolo district hospital and two health centers, Bvumbwe and Thekerani, these facilities were selected as they have a maternity wing. The decision to increase the sample size will depend on data saturation as the study progresses. Ethnographically, we will employ participant observations of health workers’ HIV testing service delivery in late pregnancy and postpartum period; during discharge from the ward and at all the visits a woman makes during the postnatal period. Expected findings and their dissemination. The findings will clarify the pathways for postpartum HIV services for the district to improve its delivery and will determine a service delivery strategy that will be applied in another phase of the study to improve testing in the postpartum period. The results will also inform policymakers like the Malawi Ministry of Health and partners on evidence-based interventions to increase HIV retesting in women thus contributing to the Sustainable development goals (SDG) 3 “ensuring healthy lives and promoting well-being for all” by optimizing HIV retesting thereby reducing HIV and AIDS-related morbidity and mortality in children. The research results will be disseminated through conferences to stakeholders such as the Malawi Ministry of Health Department of HIV and AIDS Unit, Thyolo District Health Office as well as College of Medicine Research Ethics Committee (COMREC). The results will also summarized in policy briefs and be presented at international research conferences and published in peer-reviewed journals.