Qualitative Assessment of Factors Affecting Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programs in University Teaching Hospitals in Anambra State, Nigeria

Download Article

DOI: 10.21522/TIJPH.2013.05.03.Art008

Authors : Michael Olugbamila Dada, Ogbodo UchechukwuChibuzo, Amosu, Ademola M


Background: Human Immunodeficiency Virus (HIV) infection in newborns is one of the leading causes of infant mortality globally and accounted for about 1.8million childhood deaths in 2010. Despite international interventions aimed at reducing pediatric infections at antenatal clinic entry points, however, there is still limited access and utilization of Prevention of Mother to Child Transmission (PMTCT) services resulting in low target coverage due to obstacles existing at facility, community and state levels. Anambra State still records a low patronage of PMTCT interventions by pregnant mothers.

Objective:  This study was carried out to determine the factors affecting prevention of mother-to-child transmission (PMTCT) of HIV programs in university teaching hospitals in Anambra state, Nigeria qualitatively.

Methods: This is a descriptive cross-sectional study involving 128 randomly selected HIV positive pregnant women attending antenatal care clinics and service providers of two purposively selected teaching hospitals in Anambra state, Nigeria. Qualitative data were obtained through focus group discussions and key in-depth informant interviews. Data analysis was carried out using NVivo version 9 qualitative data analysis Software.

Results: The findings of this work show that ninety-nine percent (99%) of the study participants knew that HIV was a deadly virus transmitted through sex and other blood contact routes. Seventy six percent (76%) of the participants knew that HIV could be transmitted from mother to child, while about 53% of them knew the major ways of MTCT of HIV. The participants that did not know how HIV could be passed from mother to child were 41%. Others factors are lack of awareness and knowledge about HCT, late presentation at ANC clinics, low numbers of PMTCT centers within locality of respondents, poor involvement of male partners/spouses and stigma were the main reasons cited for poor utilization of PMTCT programs in the state.

Conclusion: The study highlights a referral linkage of traditional birth attendants to health facilities for PMTCT interventions in the state to have profound impact on the health of the mother, child and nation at large.

Keywords: Human immunodeficiency virus (HIV), Prevention of mother to child transmission (PMTCT), HIV counselling and testing, Antenatal Care.


[1]. Anigilaje, E.A., Ageda, B.R. and Nweke, N.O. (2016). Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria. Dove Medical Press, 10:57-72.

[2]. Barker, P.M., Mphatswe, W. and Rollins, N. (2011). “Antiretroviral drugs in the cupboard are not enough: the impact of health systems' performance on mother-to-child transmission of HIV,” Journal of Acquired Immune Deficiency Syndromes, Vol. 56, No. 2, pp. e45–e48.

[3]. Chinkonde, J.R., Sundby, J. and Martinson, F. (2009). “The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: why do so many women drop out,” Reproductive Health Matters, Vol. 17, No. 33, pp. 143–151.

[4]. Dabis, F., Newell, M.L., L. Fransen, L. et al. (2000). “Prevention of mother-to-child transmission of HIV in developing countries: recommendations for practice,” Health Policy and Planning, vol. 15, no. 1, pp. 34–42.

[5]. Deressa, W., Seme, A., Asefa, A., Teshome, G. and Enqusellassie, F. (2014). Utilization of PMTCT services and associated factors among pregnant women attending antenatal clinics in Addis Ababa, Ethiopia. BMC Pregnancy and Childbirth Vol. 14 p.328-341.

[6]. Ezeanolue, E.E., Obiefune, M.C., Yang, W., Obaro, S.K., Ezeanolue, C.O., Ogedegbe, G.G. (2013). Comparative effectiveness of congregation-versus clinic-based approach to prevention of mother-to-child HIV transmission: study protocol for a cluster randomized controlled trial. Implement Sci. 8(1):62.

[7]. Federal HIV/AIDS Prevention and Control Office (2011). In Multi-sectoral HIV/AIDS Response Annual Monitoring and Evaluation Report 202 EFY.

[8]. Federal Ministry of Health. (2003). National HIV/AIDS and Reproductive Health Survey (NARHS).

[9]. Link B. and Phelan, J. (2001). On stigma and its public health implications. Paper presented at: Stigma and Global Health: Developing a Research Agenda; Bethesda, MD. Washington: National Institutes of Health.

[10].  Manzi, M., Zachariah, R., Teck, R. etal. (2005). “High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: scaling-up requires a different way of acting,” Tropical Medicine and International Health, Vol. 10, No. 12, pp. 1242–1250.

[11].  NACA (2012). National Agency for the Control of AIDS; Nigeria Global AIDS Response, Country Progress Report. Nigeria: Abuja.

[12].  National Agency for the Control of AIDS (2011). Factsheet 2011: Update on the HIV/AIDS Epidemic and Response in Nigeria.

[13].  Nguyen, T.A., Oosterhoff, P., Ngoc, Y.P., Wright, P. and Hardon, A. (2008). Barriers to access prevention of mother-to-child transmission for HIV-positive women in a well-resourced setting in Vietnam. AIDS Res Ther 17:5-7.

[14].  Nkwo, P. (2013). Prevention of mother to child transmission of Human Immunodeficiency Virus: The Nigerian perspective. Annals of Medical and Health sciences Research. 2(1):56–65.

[15].  Painter, T.M., Diaby, K.L., Matia, D.M., etal. (2004). “Women's reasons for not participating in follow up visits before starting short course antiretroviral prophylaxis for prevention of mother to child transmission of HIV: qualitative interview study,” British Medical Journal, Vol. 329, No. 7465, pp. 543–546.

[16].  Siegfried, N., van der Merwe, L., Brocklehurst, P. and Sint, T.T. (2011). “Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection,” Cochrane Database of Systematic Reviews, no. 7, p. CD003510.

[17].  Theilgaard, Z.P., Katzenstein, T.L., Chiduo, M.G. et al. (2011). “Addressing the fear and consequences of stigmatization—a necessary step towards making HAART accessible to women in Tanzania: a qualitative study,” AIDS Research and Therapy, Vol. 8, No. 1, p. 28.

[18].  UNAIDS, (2013). Progress report on the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

[19].  UNAIDS (2011). UBRAF 2012-2015 Country Case Study: Nigeria. Geneva.

[20].  United Nations AIDS Program (2010). http://www.unaids.org/globalreport/Global_report.htm

[21].  United Nations AIDS Program (2008). Epidemiological Fact Sheet on HIV and AIDS: Core Data on Epidemiology and Response. Ethiopia.

[22].  UNAIDS (2005). HIV-related stigma, discrimination and human rights violations: case studies of successful programs.

[23].  World Health Organization (2005). The World Health Report, Geneva, Switzerland.

[24].  World Health Organization (2006). Antiretroviral Drugs for treating Pregnant women and preventing infection in Infants: Towards Universal Access: Recommendations for a Public Health Approach, WHO, Geneva, Switzerland.

[25].  World Health Organization (2007). Prevention of Mother to Child Transmission (PMTCT). Briefing note, Department of HIV/AIDS.

[26].  World Health Organization (2010). New guidance on prevention of mother-to-child transmission of HIV and infant feeding in the context of HIV.

[27].  World Health Organization (2010). “Towards Universal Access Progress Report.

[28].  Zachariah, R., Ford, N., Philips, M., etal. (2009). Task shifting in HIV/AIDS: Opportunities, challenges and proposed actions for sub-Saharan Africa. Trans R Soc Trop Med Hyg.103:549–558.