EFFECT OF TRAINED VOLUNTEER HEALTH WORKERS ON KNOWLEDGE AND UPTAKE OF PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES AMONG WOMEN OF REPRODUCTIVE AGE IN SHENDAM LOCAL GOVERNMENT AREA, PLATEAU STATE

Abstract

Each year, more than 700,000 children are born infected with HIV; over 90% of these children contract the infection from their mothers during pregnancy, labour and delivery or breast feeding. In Nigeria, the total number of infants at risk of MTCT, assuming no multiple pregnancies is 259,000 with an estimated MTCT rate of 25-40%. The number of HIV positive infants born per annum is 64,900-103,840. The objective of the study was to determine the effect of training VHWs on knowledge and uptake of PMTCT services among women of reproductive age in the communities.
The study was a community-based, interventional study with pre- and post interventional components using married women of reproductive age and fathers of children less than one in Shendam (intervention) and Mikang (control) local government areas. Eight hundred and thirty three respondents, for both groups, were selected through multi-stage sampling technique. Trained Volunteer Health Workers carried out house to house health education intervention for three months. The knowledge and uptake of PMTCT among respondents were determined at pre and post-intervention using interviewer administered questionnaire and 6 Focus Group Discussion sessions.

Data generated at baseline and post- intervention were processed and analyzed by the use of the EPI info 3.4.2 version 2005 statistical software. Qualitative variables such as levels of education, religion, occupation were presented as percentages, while quantitative variables such as age were described using mean and standard deviation. The chi-square test was used to determine possible association between certain socio-demographic variables and intervention outcomes in the two groups. Data extracted from the catchment primary health care centres on the uptake of HIV services were presented using graphs. The qualitative data from Focus Group Discussion was transcribed during and after the fieldwork. The analysis was based on the objectives of the study; direct quotes from the respondents were also used. A confidence interval of 95% was used in this study and a p- value of 0.05 considered significant.
At base-line, the awareness of HIV/AIDS was 96.9% among the respondents in the intervention group and 95.2% in the control group. There was further improvement in awareness after intervention to 99.0% among the respondents in the intervention group. The percent of respondents in the intervention group with fair comprehensive knowledge of PMTCT improved from 54.5% to 67.8% at pre and post-intervention respectively, while in the control group it slightly declined from 58.1% to 57.5% at the beginning and end of the study. The percent of men that shared HIV test results with their partners among the intervention population improved from 40.2% to 54.5% as compared to a marginal improvement from 42.1% to 44.2% among the control group. PMTCT uptake among pregnant women in the intervention population improved from 58.1% to 65.4% compared to 62.7% to 63.0% in the control group. There was also 75% increase in HCT uptake among adult males in the intervention group at the catchment primary health care centres post-intervention as compared to the 16% decline observed in the control group at the end of the study.

This study has demonstrated that the use of VHWs has significantly improved the knowledge and uptake of PMTCT among women of reproductive age in the intervention population. Therefore, this approach can be used to improve the low uptake of PMTCT services in the state and house to house HIV counselling and testing be implemented so as to gain male involvement in terms of support for PMTCT.

EFFECT OF TRAINED VOLUNTEER HEALTH WORKERS ON KNOWLEDGE AND UPTAKE OF PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV SERVICES AMONG WOMEN OF REPRODUCTIVE AGE IN SHENDAM LOCAL GOVERNMENT AREA, PLATEAU STATE