Factors associated with enrolment of HIV infected pregnant women and mothers into care and treatment centers in Morogoro rural district, Tanzania

Abstract

Background: In Tanzania, enrolment into care and treatment centers (CTC) for those in need of anti-retroviral therapy is estimated to be 22.2%, indicating that the gateway to accessing CTC services is being underutilized. It is well-known that barriers to accessing these services affect women disproportionately, particularly during pregnancy when prevention of mother to child transmission (PMTCT) is most needed. This study explored factors associated with CTC enrolment of HIV infected pregnant women and mothers who are refereed from PMTCT services in Morogoro, Tanzania.
Methods: A cross sectional quantitative study was conducted in 30% (16) of all the available health facilities that provide RCH service in the Morogoro rural district of Tanzania. All HIV infected pregnant women and mothers attending RCH services on the day of data collection were recruited and interviewed at exit using semi-structured questionnaire.
Results: A total of 93 (72.1%) out of the recruited 129 HIV infected mothers had been referred from PMTCT and enrolled into CTC services. Social demographic characteristics such as age, marital status, education and parity showed no statistical significant association with CTC enrolment. Although factors such as distance to clinic, transport cost to clinic and possession of phone contact of provider were highly associated with CTC enrollment in the bi-variate analysis, this association disappeared after multivariate analysis. Subsequently, the multivariate analysis revealed that disclosure of HIV status to spouse (χ² value =28.4; P value< 0.001.) and home visits by CHWs were statistically significantly associated with enrollment into CTC services.
Conclusion: Disclosure of one’s HIV status to a spouse and home visits by CHWs were found to be highly associated with CTC enrolment. These findings suggest that despite women’s apprehension about HIV status disclosure because they fear stigmatization, PMTCT providers should continue to encourage them to share their HIV status with their partners. Providers should also encourage CHWs to visit homes to encourage pregnant women and lactating mothers to enroll into CTC services, in order to improve continuity of service utilization from PMTCT to CTC enrolment and to other Maternal and Newborn Child Health services.

Key words: HIV Infected mothers, Care and treatment Centres, Enrollment into care, PMTCT