PMID- 20565930
OWN - NLM
STAT- MEDLINE
DCOM- 20130214
LR  - 20211020
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 10
DP  - 2010 Jun 21
TI  - Prevention of mother-to-child transmission of HIV infection: views and 
      perceptions about swallowing nevirapine in rural Lilongwe, Malawi.
PG  - 354
LID - 10.1186/1471-2458-10-354 [doi]
AB  - BACKGROUND: In 2006 the World Health Organization described the status of 
      prevention of mother to child transmission (PMTCT) service implementation as 
      unacceptable, with an urgent need for a renewed public health approach to improve 
      access. For PMTCT to be effective it needs to be accessible, acceptable and 
      affordable; however research in Africa into accessibility, uptake and 
      acceptability of PMTCT services has been predominately urban based and usually 
      focusing on women who deliver in hospitals. The importance of involving other 
      community members to strengthen both PMTCT uptake and adherence, and to support 
      women emotionally, has been advocated. Urban men's and rural traditional birth 
      attendants' (TBAs) involvement have improved uptake of HIV testing and of 
      nevirapine. METHODS: A qualitative study was carried out in a rural district of 
      Malawi's central region to explore the views about and perceptions of PMTCT 
      antiretroviral treatment. Semi-structured interviews and focus group discussions 
      were held with antenatal and postnatal women, fathers, grandmothers, TBAs, 
      community leaders and PMTCT health workers. RESULTS: Two broad themes of findings 
      emerged: those that relate to the hospital PMTCT service, and those that relate 
      to the community. Trust in the hospital was strong, but distance, transport costs 
      and perceived harsh, threatening health worker attitudes were barriers to access. 
      Grandmothers were perceived to have influence on the management of labour, unlike 
      fathers, but both were suggested as key people to ensure that babies are brought 
      to the hospital for nevirapine syrup. TBAs were seen as powerful, local, and 
      important community members, but some as uneducated. CONCLUSION: PMTCT was seen 
      as a community issue in which more than the mother alone can be involved. To 
      support access to PMTCT, especially for rural women, there is need for further 
      innovation and implementation research on involving TBAs in some aspects of PMTCT 
      services, and in negotiating with women which community members, if any, they 
      would like to support them in ensuring that newborn babies receive nevirapine.
FAU - O'Gorman, Deirdre A
AU  - O'Gorman DA
AD  - Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. 
      sjt@liv.ac.uk.
FAU - Nyirenda, Lot J
AU  - Nyirenda LJ
FAU - Theobald, Sally J
AU  - Theobald SJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100621
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
RN  - 0 (Anti-HIV Agents)
RN  - 99DK7FVK1H (Nevirapine)
SB  - IM
MH  - Administration, Oral
MH  - Adult
MH  - Aged
MH  - Anti-HIV Agents/*administration & dosage
MH  - *Attitude to Health
MH  - Female
MH  - Focus Groups
MH  - HIV Infections/drug therapy/prevention & control/*transmission
MH  - Health Services Accessibility
MH  - Humans
MH  - Infant, Newborn
MH  - Infectious Disease Transmission, Vertical/*prevention & control
MH  - Interviews as Topic
MH  - Malawi
MH  - Middle Aged
MH  - Nevirapine/*administration & dosage
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*drug therapy
MH  - Qualitative Research
MH  - Rural Population
MH  - Young Adult
PMC - PMC2910675
EDAT- 2010/06/23 06:00
MHDA- 2013/02/15 06:00
PMCR- 2010/06/21
CRDT- 2010/06/23 06:00
PHST- 2009/06/16 00:00 [received]
PHST- 2010/06/21 00:00 [accepted]
PHST- 2010/06/23 06:00 [entrez]
PHST- 2010/06/23 06:00 [pubmed]
PHST- 2013/02/15 06:00 [medline]
PHST- 2010/06/21 00:00 [pmc-release]
AID - 1471-2458-10-354 [pii]
AID - 10.1186/1471-2458-10-354 [doi]
PST - epublish
SO  - BMC Public Health. 2010 Jun 21;10:354. doi: 10.1186/1471-2458-10-354.