Barriers to Retention in HIV Infected Children on ART: Improvement Strategies at Kaduna State Comprehensive Health Care Facilities in Nigeria

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DOI: 10.21522/TIJPH.2013.07.04.Art017

Authors : S Batanda, Mduluza T, Godfrey Yikii


Objectives: Identified factors that contributed to poor retention in care of HIV infected children initiated on Anti-Retroviral Treatment and recommended appropriate improvement strategies.

Study design: A total of 134 individuals were selected using purposive sampling and participated in the Focused Groups Discussions (FGDs), drawn from Caregivers support groups, HIV positive adolescents and health care workers at the ART clinics.

Methods: Exploratory qualitative method using FGD questionnaire guide and retrospective review of secondary cohort clinical data records covering a period of 12 months was conducted using standardized data abstraction forms.

Results: There were few studies that had been conducted in Nigeria to explore enablers of retention in care of HIV positive children. However, similar studies from other settings exited. Barriers to retention in care were the most commonly reported across the FGDs, though enablers were also reported. There was also a significant correlation between participant’s responses and data analyzed from the hospital records.

Conclusion: It was mostly barriers to retention in care that were reported. Some barriers, however, were reported as enablers to retention in care. Caregiver’s role is critical and additional integrated strategies are urgently required to achieve optimum retention in care of children.

Keywords: Retention in care; HIV positive children, Barriers to retention, Enablers to retention, Loss to follow up, Caregivers.


[1].      AHF-2018; Nigeria | AIDS Healthcare Foundation

[2].      Awofala, AA, 2016; HIV epidemiology in Nigeria–Science Direct https://www.sciencedirect.

[3].      Badejo AO, ‎2018; Pediatric to Adult Healthcare Transitioning for Adolescents living with...

[4].      Busza J, ‎2018; the role of community health workers in improving HIV treatment ...

[5].      Caroline De Schacht, Carlota Lucas et al.2014; Access to HIV prevention and care for HIV-exposed and ... - NCBI NIH Cited by 12Related articles.

[6].      CDC, 2008; Evaluation of Adherence to ART in Children in Nigeria Sponsored by

[7].      Chalmers L, 2014 Barriers and facilitators of adherence to antiretroviral drug therapy and retention in care among adult HIV-positive patients: a qualitative study from Ethiopia.10.1371/journal.pone.0097353.

[8].      Crossman Ashley, 2018; Purposive Sampling Definition and Types – Thought Co Sociology › Key Theoretical Concepts Apr 1, 2018.

[9].      Databases, A-to-Z, 2018; Electronic Resources - Research Guides at United... › ... › Research Guides › Electronic Resourceful 24, 2018 - Your library provides access to many online databases. Use the tabs in this resource guide to find databases by title or by subject category.

[10].  Davis Vicki, 2014; Note Taking Skills for 21st Century Students @coolcatteacherntury-students.

[11].  FHI 360, 2017); Better HIV care: Differentiated models of care across the HIV - FHI 360 Paper.

[12].  Geng EH-2010; Centre for Biotechnology Information.

[13].  Schouten EJ-2011;

[14].  Harries AD, ‎2010; Identifying common barriers and facilitators to linkage and retention in chronic disease care in western Kenya.

[15].  Holmes CB, ‎2018; estimated mortality on HIV treatment among active patients and

[16].  Holmes J 2015: SamplingScienceDirect S016745280.

[17].  Koirala S, ‎2017; Facilitators and barriers for retention in HIV care between testing and treatment in Asia—A study in Bangladesh, Indonesia, Lao, Nepal, Pakistan, Philippines and Vietnam PLOS Published: May 1, 2017

[18].  Korstjens I- ‎2017 Practical guidance to qualitative research. Part 2 - Taylor & Francis...

[19].  Krueger RA, 2002; Designing and conducting focus group Guidelines/Nigeria_art.p.

[20].  Labaree RV, ‎2009; The Literature Review - Organizing Your Social Sciences guide/literature review.

[21].  Ledda C, ‎2017; Attitude of Health Care Workers (HCWs) toward Patients Affected by

[22].  Levine CA, ‎2017; Ethical Considerations: Conducting Retrospective ... - Value in Health (17)33394-6/full text

[23].  Massavon W, ‎2014 Factors Determining Survival and Retention among HIV ... - NCBI - NIH Published online 2014 Apr 1. Doi: 10.1155/2014/852489. PMCID: PMC4003865.

[24].  Methley AM, ‎2014 PICO, PICOS and SPIDER: a comparison study of specificity and

[25].  Meresa B, Seifu Ali W - 2018 Predictors of loss to follow up among adult clients attending antiretroviral treatment at Karamara general hospital, Jigjiga town, Eastern Ethiopia, 2015: a retrospective cohort study. BMC Infect Dis. 2018 Jun 18; 18(1):280. Doi: 10.1186/s12879-018-3188-4.PMID:

[26].  Miller FG, 2008; Research on Medical Records without Informed Consent

[27].  Messeri PA, ‎ 2002; Center for Biotechnology Information. PEPFAR-2012; HIV/AIDS in Nigeria - PEPFAR

[28].  Noyes J & Lewin 2011; data extraction Cochrane. Method https://cochrane.ort/.../method.cochrane/extraction%20chapter version

[29].  NACA, 2015; Benue State HIV and AIDS Epidemiology and Impact

[30].  NACA, 2016; FACT SHEET Anti-Retroviral Therapy (ART) 2016 - NACA Nigeria

[31].  PEPFAR-2012; Nigeria National Guidelines for HIV/AIDS Treatment and Care HIV/AIDS in Nigeria - PEPFAR

[32].  Pilgrim NA - ‎2018; Challenges to and opportunities for the adoption and routine use of (change for Pediatr. MC; 2018)

[33].  Rabiee F, ‎2004; Focus-group interview and data analysis-CiteSeerX

[34].  Rivenburgh N, 2012; The Purpose of the Literature Review

[35].  Rawizza HE - ‎2015; Loss to Follow-up within the Prevention of Mother-to-Child ...

[36].  Rumbold JMM – 2017; JMIR-The Effect of the General Data Protection Regulation on Medical

[37].  Sally, 2018; Purpose of a Literature Review - Academic Coaching & Writing w.

[38].  Seifu W - ‎2018; Predictors of loss to follow up among adult clients attending ... - NCBI Jun 18, 2018 - Seifu W(1), Ali W(2), Meresa B(3). ... to follow up among adult ART clients attending in Karamara Hospital, Jigjiga town, Eastern Ethiopia, 2015.

[39].  SJI- 2008; - How Are People in Focus Groups

[40].  UNICEF-2006, Millions of Nigerian children devastated by HIV/AIDS - Unicef

[41].  Stephanie P, 2015; Purposive Sampling (Deliberate Sampling) – Statistics,

[42].  University of Edinburgh, 2018; References/

[43].  Ubesie AC, ‎2017 Outcomes of Paediatric HIV care at the University of Nigeria Teaching

[44].  Watson Sally-Anne, 2016; Tips for recording interviews and focus groups | Sally-Anne Watson

[45].  Zürcher K, ‎2017; Outcomes of HIV-positive patients lost to follow-up in African treatment ...