Child Bearing Decisions among Women Enrolled In PMTCT Programme: A Comparative Study of the Rural and Semi-Urban Setting of Malawi Chiradzulu District
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.
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