HIV and AIDS have caused untold harm and human suffering globally. Over 90% of people
infected with this deadly virus live in sub-Saharan Africa including Malawi. In
Malawi HIV disproportionally affects women in comparison with men. According to
Demographic and Health Survey (2015-2016) key indicators, HIV prevalence among women
aged 15-64 was 12.8% compared to men 8.2% public health. As per 2010 Malawi demographic
and health survey, HIV prevalence in the southern region was twice as high as prevalence
in the other regions (Southern 14.5%, Central 7.6% and northern region (6. 6%).Women
and children are more affected than the rest of the general population. HIV infection
in children below 15 years is largely due to mother-to-child transmission (MTCT).
Worldwide, over two million children have been infected through MTCT.
of Research Study: The study adopted a qualitative research design using
the inductive research technique or grounded theory research in which the steps
occur simultaneously, observing, collecting data and forming theory from the data
at the same time.
Statement: HIV prevalence in Southern Region of Malawi is twice
as high as Northern and Central regions, at 14.5% where fertility rate at 5.7% are
also high. A combination of high fertility rate and high HIV prevalence have contributed
to the undermining of an effective PMTCT continuum of prevention, care and treatment
programme towards achieving virtual elimination of mother to child HIV transmission
and keeping the mothers alive. Therefore, there is need to examine how and through
what pathways learning about one’s HIV positive status could alter one’s childbearing decisions.
This study explored the decision-making process on pregnancy decisions among PMTCT
participants and their family support systems; Examined factors that influence decision
making process among PMTCT participants and their immediate family networks; Determined
the gaps in the PMTCT service delivery; Explored the knowledge and attitudes of
health providers PMTCT mothers; and analysed the gap between the PMTCT policy guidelines
and their implementation
study revealed factors that influence fertility decisions among pregnant women with
HIV attending ANC and ART clinic at Chiradzulu District Hospital. Some of participants
became pregnant because they desired to have another child and others because their
partners wanted a child. A proper understanding of factors associated with pregnancies
among these women is essential to guide interventions and counselling strategies
to better inform and support them. Religious doctrines, beliefs about having a healthy
baby, personal desire and familial desires to have a baby, combined with the social
stigma that accompanies HIV, puts women who are HIV-positive in a difficult situation.
HIV-positive women must be appropriately counselled about the risks of childbearing
rather than focusing only on issues related to mother-to-child transmission of HIV.
at a Health Centre in Balaka, Malawi: A Descriptive Qualitative Study1. Balaka:
N. Et. al. (2009). The Practice of Nursing Research: Appraisal, Synthesis and
Generation of Evidence (6th Ed). St Louis: Saunders Elsevier.
Kim Bui, Et. al. (2011). Pregnancy Decision-Making among HIV Positive Women in
Northern Vietnam: Reconsidering Reproductive Choice. Antropology and Medicine.
D. Et. al. (2009, June 13). Fertility Intentions and Reproductive Health Care
Needs of People Living with HIV in Cape Town, South Africa: Implications for
Intergrating Reproductive Health and HIV Care Services. pp. 38-46.
J. Et. al (2011). Designing and Conduction Mixed Methods Research. SAGE
P. Et. al (2004). Research into Practice: Essential Skills for Reading and
Applying Research in Nursing and Health Care (2nd Ed). Edinburgh: Bbailliere Tindall.
D. Y. (n.d.). Skills for Reading and Research in Nursing and Health are. In
Handbook of Qualitative Research (2nd Ed) (pp. 105-117). Califonia: Thousand
K. Et. al (2010). The Research Process in Nursing. (6th Ed). West 8: Sussex
K. Et. al (2010). The Research Process in Nursing.(6th Ed). West 8: Sussex
B. Et. al (2013). Reproductive Decision of Couples Living with HIV in Malawi:
What Can We Lean for Future Policy and Research Study? Malawi Medical Journal,
B. Et. al. (2013). Source of Information on HIV and Sexual and Reproductive
Health for Couples Living with HIV in Rural Southern Malawi. AIDS Research and Treatment,
E. G. (1994). Competing Paradigms in Qualitative Research. New Delhi: Sage
E. G. (2010). The Paradigm Dialog. SAGE Publications.
Community of Women Lliviny with HIV/AIDS (2015). Positive Women: Voices and
Choices Zimbabwe Report. Harare: ICW.
J. E. (n.d.). Socio-Cultural Factors Influencing the Prevention of
Mother-to-Child Transmission of HIV in Nigeria: A Synthesis of The Literature.
Lagos: Not Published.
A. Et. al. (2011). Childbearing Intentions of HIV-Positive Women of
Reproductive Age in Soweto, South Africa: The Influence of Expanding Access to
HAART in an HIV Hyper Endemic Setting. Not Published.
S. Et. al. (2012). Desire for Motherhood: Exploring HIV-Positive Women's
Desire, Intentions and Decision-Making in Attaining Motherhood. AIDS CARE.
F. (2010). Making it Happen: Prevention of Mother to Child Transmission of HIV
in Rural Malawi. Retrieved from Global Health Action: http://www.globalhealthaction.net/index.php/gha/article/view/370
P. Et. al. (2015). Providers Attitudes about Childbearing and Knowledge of
Safer Conception at Two HIV Clinics in Malawi. Not Published.
Et. al. (1995). A Family Planning Intervention to Reduce Vertical Transmission
of HIV in Rwanda. BMC Public Health, 45-51.
P. D. (2010). Practical Research: Planning and Design. (9th ED). Boston:
M. Et. al. (2008). Antiretroviral Therapy is Associated with Increased
Fertility Desire, but not Pregnancy or Live Birth, Among HIV+ Women in an Early
HIV Treatment Program in Rural Uuganda. Kampala: Epub. Ministry of Health
(2011). Clinical Management of HIV in Children and Adults: Malawi Intergrated
Guidelines for Providing HIV Services.
of Health (2014). Clinical Management of HIV in Children and Adults. Lilongwe:
Ministry of Health.
W. L. (1994). Social Research Methods. London: Boston Allyn and Bacon.
J. Et. al. (2010). The Divorce Program: Gendered Experiences on HIV Positive
Mothers Enrolled in PMTCT Programs: The Case of Rural Malawi.
J. Et. al. (2011). Decision Making for Women to Access Prevention of Mother to
Child Transmission Services in Blantyre and Balaka Malawi. Journal of rural and
Tropical Public Health. vol. 10, 95-100.
M. Q. (1990). Qualitative E valuation and Research Methods. (2nd Ed).
California: Sage Publications.
D. F. (2010). Nursing Research: Appraising Evidence for Nursing Practice. (8th
Ed). Philadelphia: Lippicott Williams & Wilkins.
N. Et. al. (2000). Reproductive Decision-Making in the Context of HIV and AIDS:
A Qualitative Study in Ndola, Zambia. Ndola: International Family Planning.
A. &. (1998). Basic of Qualitative Research: Techniques and Procedures for
Developing Grounded Theory (2nd Ed). London: Thousand Oaks.
(2011). HIV and Infant Feeding: Guidelines for Decision Makers. Geneva: WHO.
H. F. (1980). Ethnographic Research in Education. Washington DC: American
Educational Research Association.