Factors influencing utilization and adherence to Prevention of Mother to Child Transmission of HIV/AIDS services in Rivers State, Nigeria

Effectiveness of services for Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) depends on viable and efficient health systems, adherence to and utilization of services. Despite strategies to provide access to PMTCT of HIV services, utilization of these services remain low in Nigeria thereby increasing child morbidity and mortality from HIV-related causes. Adherence to comprehensive HIV/AIDS care, for both the mother and baby, remain a challenge for HIV positive women. Utilizing the Health Belief Model and Social Support Theory, this qualitative study explores factors influencing utilization and adherence to PMTCT services by mothers living with HIV/AIDS in Rivers State, Nigeria. Purposive sampling procedures were used to select 40 study participants including 20 HIV positive mothers and 20 health care workers as key informants. Findings indicate that high self-perceived susceptibility to HIV influences utilization and adherence to PMTCT services among mothers living with HIV and AIDS in Rivers State. Although utilization and adherence to PMTCT were reported very high among this population, there were however challenges and barriers to optimal utilization of PMTCT. These include unavailability of test kits, antiretroviral medication stock-outs, and inadequate human resources for health. High transport, PMTCT and antenatal care costs were identified as the major socio-economic barriers to PMTCT administration as well as the high financial burden of formula feeding for women that preferred exclusive formula feeding. In addition to increased numbers of health care workers trained in PMTCT service delivery, recommendations for a public health approach to service delivery and a streamlined primary care strategy are proposed. These include social and community activities to address HIV/AIDS stigma, improving awareness of PMTCT facts, addressing gender relations and encouraging male participation. Inter-ministerial collaborations and targeted partnerships are also recommended for expanding coverage and ensuring optimal utilization of PMTCT services

Sustainable Development in Developing Countries: Case Studies of Sustainable Consumption and Production in South Africa and India

The pursuit of development has had a major impact on the environment and on existing social structures. During the 1950s and 1960s, most nations were preoccupied with economic growth and energy consumption, which led to social and environmental issues being overlooked. Thus, traditional societies have been devastated and extreme environmental damage occurring such as pollution and inadequate water supply, transportation and sewer infrastructure problems amongst others. If environmental damage remains unchecked, the achievements of development and even essential ecosystems would be undermined. This paper reviewed the link between growth trends and sustainable development in Sub-Saharan Africa. Thereafter, the impact of environmental degradation was discussed including strategies for sustainable energy production and consumption. These were based on evidence from South Africa and India and provided the benchmark for discussing ways in which energy production and consumption can take place sustainably. The paper notes that in developing and implementing strategies, emerging countries do not necessarily have to be western in their sustainable development policies. Rather, each country has to have sustainable development policies that are peculiar to its own circumstance. The paper recommends community participation and accountability of institutions as necessary for ensuring that social development is integrated into the economic and environmental elements of sustainable development

Prevention of mother to child transmission (PMTCT) of HIV/AIDS: a review of using PMTCT services in South Africa

Despite good intentions and commitment from health providers, it is difficult for HIV positive pregnant women to access Prevention of Mother to Child Transmission of HIV (PMTCT) services (Skinner et al 2005:115). The aim of this research was to find out the extent to which socio-economic and cultural factors influence access to and utilization of PMTCT services. It appeared that despite having a legal plan and framework to ensure that PMTCT services are available and free, the realities confronting HIV positive women in South Africa as suggested by the literature contradicted this objective. Inevitably, these contradictions were identified as some of the main factors contributing to lack of access and inadequate utilization of PMTCT services. These factors were identified through a review of fifteen studies selected based on their relevance to the research aim. The findings were presented according to the following themes: Functioning of clinics, adherence to ART, uptake of VCT and infant feeding practices. According to research evidence, the major socio-cultural factors influencing access and utilization of PMTCT services include fear of stigma and discrimination which are related to cultural norms and practices. The socio-economic factors include transport costs, lack of food, medicines and formula milk which are all related to poverty and unemployment. The research also found that health system constraints such as long waiting times in clinics, stock-outs of formula milk, medicines and test kits influenced the utilization of PMTCT services by HIV positive women

Prevention of mother to child transmission (PMTCT) of HIV/AIDS: a review of using PMTCT services in South Africa

Despite good intentions and commitment from health providers, it is difficult for HIV positive pregnant women to access Prevention of Mother to Child Transmission of HIV (PMTCT) services (Skinner et al 2005:115). The aim of this research was to find out the extent to which socio-economic and cultural factors influence access to and utilization of PMTCT services. It appeared that despite having a legal plan and framework to ensure that PMTCT services are available and free, the realities confronting HIV positive women in South Africa as suggested by the literature contradicted this objective. Inevitably, these contradictions were identified as some of the main factors contributing to lack of access and inadequate utilization of PMTCT services. These factors were identified through a review of fifteen studies selected based on their relevance to the research aim. The findings were presented according to the following themes: Functioning of clinics, adherence to ART, uptake of VCT and infant feeding practices. According to research evidence, the major socio-cultural factors influencing access and utilization of PMTCT services include fear of stigma and discrimination which are related to cultural norms and practices. The socio-economic factors include transport costs, lack of food, medicines and formula milk which are all related to poverty and unemployment. The research also found that health system constraints such as long waiting times in clinics, stock-outs of formula milk, medicines and test kits influenced the utilization of PMTCT services by HIV positive women

Health sector reforms: implications for maternal and child healthcare in South Africa

Generally, public health facilities in developing countries tend to be underfunded and inefficient. In South Africa, these problems have continued even after the introduction of free maternal and child health care policy. It is argued that this policy increased utilization rate and consequently overcrowding of public health facilities. Nonetheless, long waiting times and unavailability of certain drugs continue to serve as major barriers to accessing health facilities in South Africa. Available records and our findings indicate that there is lack of consistent training for health personnel, increasing workload, inadequate physical infrastructure, resources and equipment, which have made it difficult to reduce maternal mortality rates. This paper xrays health reforms in other countries vis-à-vis propositions by international organizations and posits that the free maternal and child healthcare policy in South Africa has been formulated without considering the capacity and resources necessary to implement it. As a result, its implementation only aided in increasing access to public facilities and an improvement in utilization rates with no substantial increase in the quality of the services delivery. The paper concludes that the current health reform have the potential of reducing social exclusion, nonetheless, it must be managed carefully through supportive actions in order to avoid negative impacts on the wider health system and consequent worsening of the health system.International Bibliography of Social Science

Challenges of microfinance access in Nigeria: implications for entrepreneurship development

Small and Medium Enterprises (SMEs) are increasingly being accepted as valuable platforms to create jobs and improve livelihoods. The Nigerian government has enacted favorable laws and regulations on contracts, leasing, and corporate tax to encourage the development of SMEs. Nonetheless, many entrepreneurs in Nigeria cannot access loans given the high levels of poverty. The paper argues that microenterprise finance cannot be financially viable because small loans are too costly to administer and the profits from such lending too meager to permit profitability. Based on content analysis of available literature, it is found that microfinance institutions have collapsed in Nigeria due to poor loan quality, default in loan repayment, high transaction costs, widespread delinquency, and management deficiencies. Given these challenges, the paper recommends savings by microfinance institutions and measures from successful initiatives from countries such as Indonesia and Bangladesh. These will enable microfinance institutions to be self-sustaining and to increase outreach.International Bibliography of Social Science