Barriers; Facilitators and Recommendations for the Early Infant Diagnosis and Treatment (EIDT) Cascade: A Qualitative Study in Malawi
S. Afr. j. child health (Online)
; 10(2): 116-120, 2016.
Artigo
em Inglês
| AIM (África)
| ID: biblio-1270274
Biblioteca responsável:
CG1.1
ABSTRACT
Background. Identifying and testing all HIV-exposed infants (HEIs) by 2 months of age with rapid antiretroviral therapy (ART) initiation for those infected is critical to survival. Yet in 2009 only 29% of HEIs in need of ART received treatment in Malawi.Objectives. To understand barriers; facilitators and recommendations for five key steps in the early infant diagnosis and treatment (EIDT) cascade (1) identification of HEIs; (2) infant testing; (3) sample processing and transport; (4) reporting results to mothers; (5) ART initiation for HEI.Methods. Semistructured interviews were conducted through convenience sampling with mothers of infants eligible for EIDT (n=47) and with healthcare workers (HCWs) providing EIDT (n=20) in five facilities; in April 2013. Results. (1) Reliance on the health passport to identify HEIs is both barrier; as women may not attend appointments with their passports; and facilitator; for documentation of HIV-exposure status. Use of trained health surveillance assistants in EIDT enhances cascade steps 1 and 2; but requires increased supervision. (2) Women struggle to accept their own HIV status; yet test results for an HEI is a motivator. Sensitisation through local leadership facilitates EIDT. (3) A reliable transport system is needed. (4) Maintaining appointments to report results to women motivates them. (5) Mothers were reluctant to give ART to young; apparently healthy infants. Conclusion. Both women and healthcare workers are motivated by test results for HEIs. The inclusion of community education can improve all steps in the EIDT cascade; including information that HEIs need ART
Texto completo:
Disponível
Base de dados:
AIM (África)
Assunto principal:
Infecções por HIV
/
Diagnóstico Precoce
Tipo de estudo:
Estudo diagnóstico
/
Guia de prática clínica
/
Pesquisa qualitativa
/
Estudo de rastreamento
Idioma:
Inglês
Revista:
S. Afr. j. child health (Online)
Ano de publicação:
2016
Tipo de documento:
Artigo