`Keeping Healthy in the Backseat': How Motherhood Interrupted HIV Treatment in Recently Delivered Women in Kenya

Although there is a large body of literature related to the experiences of motherhood and aspects of the change that it brings about; how the experience of motherhood affects the healthcare of women with chronic illness is less documented. This study explores how motherhood in newly delivered HIV-infected mothers in Kenya interrupted their antiretroviral treatment (ART). Qualitative interviews were performed with 26 mothers on ART in a rural or urban area. The data were organised and interpreted using content analysis. The study found that adherence to ART was influenced by contextual differences in socio-cultural expectations and family relationships. Urban life enabled women to make decisions on their own and to negotiate challenges that were often unpredictable. Women in rural areas knew what was expected of them and decisions were normally not for them to make alone. The women in Busia and Kibera had difficulties combining adherence with attaining the socio-cultural definition of good mothering. Lack of support from health providers and weak healthcare systems contributed to inadequate stocks of HIV drugs and inaccessibility of HIV-related care. From the data; we developed the main theme `keeping healthy in the backseat' and the two sub-themes `regaining self-worth through motherhood' and `mother first - patient later.' We suggest that motherhood is context-specific and follows socio-cultural practises; which made it difficult for the women in Kenya to follow ART instructions. There is a need to reassess HIV-related services for mothers on ART in order to give them a better chance to stay on treatment and satisfy their aspiration to be `good mothers.' Contextspecific HIV-treatment policies are necessary for ensuring adherence and successful treatment outcomes

Assessment of Inhalation Technique among Asthmatic Children and their Carers at the Kenyatta National Hospital; Kenya

The aim of this study was to evaluate the correctness of use of pressurised metered-dose inhalers and spacer devices and to determine the common errors in the inhalation technique and factors associated with incorrect technique. The descriptive cross-sectional survey took place in the Kenyatta National Hospital; Nairobi; Kenya. Eighty-two asthmatic children aged 6 months to 12 years (median age 45 months; 56males) on inhaler medications and their carers were recruited into the study and assessed for correctness of inhalation technique. Of the 82 subjects; only 37 (45.1) performed all the essential steps of the inhalation technique correctly. The commonest errors were failure to take adequate breaths after actuation of inhaler (45) and not shaking the inhaler before use (18). The characteristics of correct and incorrect users are mainly similar. It was concluded that the majority (55) of asthmatic children and their carers do not perform the inhalation technique correctly