Assessment of utilisation of PMTCT services at Nyanza Provincial Hospital, Kenya

The main objective of the study was to assess the utilisation of prevention of mother-to-child transmission (PMTCT) services among mothers registered for services at Nyanza Provincial Hospital in Kenya. A crosssectional exploratory study was conducted, using both quantitative and qualitative approaches to collect primary and secondary data.The study 52.4% of clients received PMTCT information at the health facility without prior knowledge about intervention, 96% waited for more than 90 minutes, and 89% took less than 10 minutes for post-test counselling. Knowledge of MTCT and PMTCT was inadequate even after counselling, as participants could not recall the information divulged during counselling. In addition, 80% of clients did not present for follow-up counselling irrespective of HIV status, and 95% did not disclose positive HIV status to spouses/relatives for fear of stigma, discrimination and violence. Inadequate counselling services delivered to clients affected service utilisation, in that significant dropout occurred at the stages of HIV result (31.5%), enrollment (53.6%), and delivery (80.7%). Reasons for dropout included fear of positive HIV result, chronic illness, stigma and discrimination, unsupportive spouse and inability to pay for the services.Key Words:utilisation, PMTCT services, Nyanza Hospital, Kenya.R&#201SUM&#201Le but principal de cette &#233tude fut d&#39&#233valuer l&#39utilisation des services PMTCT parmi les m&#233res inscrites aux services de l&#39hôpital provincial Nyanza. Une &#233tude transversale et exploratoire a &#233t&#233 faite durant laquelle les approches quantitatives et qualitatives furent utilis&#233es afin de recueillir des donn&#233es primaires et secondaires. La population d&#39&#233tude furent 133 clients inscrits aux services PMTCT. Cette &#233tude a montr&#233 que 52.4% de clients ont eu les informations sur le PMTCT au centre m&#233dical même sans avoir la connaissance pr&#233alable de l&#39intervention, 96% ont attendu plus de 90 minutes et 89% ont subi la consultation après le dépistage qui a duré moins que 10 minutes. La connaissance sur le MTCT et le PMTCT fut inadéquate même après la consultation, étant donné que les participants ne pouvaient plus se rappeler l'information qu'on leur a donné lors de la consultation. Ceci a aussi démontré 80% de manque de suivi après la consultation sans tenir compte du statut sérologique et 95% ne dévoilent pas leur statut sérologique positif à leur époux(se)/membres de famille de peur de stigmatisation, de discrimination et de violence. Les services de consultation inadéquats mis à la disposition de clients ont un effet sur l'utilisation de services, parce que un grand nombre de clients laissent tombé la consultation après les résultats du dépistage (31.5%), les inscriptions (53.6%) et le service rendu (80.7%). Les raisons de laisser tombé comprennent la peur de connaître son statut sérologique, les maladies chroniques, la stigmatisation et la discrimination, un(e) époux(se) qui n'offre pas de soutien et l'incapacité de payer pour les services. Mots clés: utilisation, services PMTCT, hôpital Nyanza, le Kenya.Journal of Social Aspects of HIV/AIDS Vol 2(2) 2005: 244-25

Home Management Of Diarrhea Among Underfives In A Rural Community In Kenya: Household Perceptions And Practices

Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. Objective: The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. Design: A household longitudinal study was conducted in Nyando district, Kenya in 2004-2006 adopting both qualitative and quantitative approaches. Subjects: A total of 927 mothers/caregivers of under-fives participated in the study. Main outcome measures: Perceived causes of childhood diarrhoea, action taken during diarrhea, fluid intake, recognition of signs of dehydration, feeding during convalescence, adherence to treatment and advice. Results: Majority of the respondents 807(87.1%) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48% of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524(55.6%), contaminated food 508(54.9%), bad eye 464 (50.0%), false teeth 423(45.6%) and breast milk 331(35.8%). More than 70% of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour, rice water and selected herbs as anti-diarrheal agents. During illness, 239(27.8%) of the children were reported not to have drunk any fluids at all, 487(52.5%) drunk much less and only 93(10.0%) were reported to have drunk more than usual. A significant 831(89.6%) withheld milk including breast milk with the notion that it enhanced diarrhea. Conclusion: Based on these findings, there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and misconceptions and facilitate positive change in the household practice on management of diarrhea among under-fives. East African Journal of Public Health Vol. 5 (3) 2008: pp. 142-14