A.B. Petersen

J.K. Cataldo

L.M. Thompson

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MDGs and SDGs A n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6M a yeJ u n e 2 0 1 6 : 5 1 1 – 5 3 1520Outcome/Evaluation: Quantitative and qualitative methods wereused to evaluate how well implementation followed the originalprotocol or program design and plans. Lot Quality AssuranceSampling was used to assess changes in health behaviors of directbeneficiaries across more than 37 MNCHN indicators in each studysite. Methods used included key informant interviews, documentreview, direct observation of CHW visits, surveying direct beneficia-ries about CHW visits, focus group discussions with communitymembers. LQAS data was analyzed across study site as a whole, andin each of 4-8 supervision areas to identify high, low performance.Going Forward: After basic analysis participatory data reviewworkshops were held with 20-40 stakeholders to discuss resultsand performance of implementing staff, partners and communitymembers. Multiple implementation areas including quality ofdelivery were identified for improvement, some intervention compo-nents were not being delivered. Following the workshops, actionableplans to accelerate improvements in implementation were created tomaximize changes in MNCHN outcomes. The plans prioritizecommunities most pressing health needs within the bounds ofproject budget, time, and staff capacity.Funding: The CHNIS study is privately funded by World Vision.Abstract #: 2.022_MDGStrategies for improving pediatric/adolescent HIVsuppression rates for patients on HAART in NigeriaA.V. Enejoh1, M. Niyang2, A. Olutola1, U. Patel3,6, J. Pharr5,6,E.E. Echezona4,6; 1Centre for Clinical Care & Clinical Research,Abuja, Nigeria, 2Maryland Global Initiative Corporation, Abuja,Nigeria, 3Georgetown University, Washington, D.C., 4University ofNevada School of Medicine, Las Vegas, Nevada, 5University of NevadaSchool of Community Health Sciences, Las Vegas, Nevada, 6Health-ySunrise Foundation, Las Vegas, NevadaBackground: Improving viral suppression rates for patients onhighly active anti-retroviral therapy (HAART) is a key goal forHIV programs. Studies have consistently shown pediatric suppres-sion rates to be lower than that of adults. In 2010, the pediatricsuppression rate for patients on the AIDSRelief Nigeria programwas 69.25% compared with 90% for adults. The aim of this studywas to test the effectiveness of interventions to increase the viralsuppression rate in pediatric HIV patients in Nigeria.Methods: Across sectional cohort study carried out as part of patient-level evaluation for quality improvementof servicedelivery atAIDSRe-lief clinical sites in Nigeria. Patients were randomly selected andreviewed to determine viral suppression rates. Measures consisted ofplasma RNA HIV -1 levels and structured interviews for pediatricpatients and their caregivers. Strategic goals put in place as interven-tions to improve suppression rate included: Identifying and document-ing a primary and an alternate caregiver for 85% of pediatric patients,the caregivers completing a new session of treatment support classes,60%of pediatric patients receiving at least one home visit in sixmonths,and 80%of all pediatric charts were to be completed.All strategies wereimplemented and a reevaluation was conducted one year later.Findings: Participants consisted of 354 HIV-positive children(< or ¼ 15 years old) on HAART for nine months or longer.Mean age was 6.62 years. 183(50.8%) were males, 49.2% females.100% of caregivers were identified and documented, 63.3 % receivedand completed a treatment support class while 36.7% of pediatricpatients received home visits. There was a decrease in incidence ofnew opportunistic infections from 76.5% in 2010 to 35.3% in2011. McNemar test demonstrated the percentage of virally sup-pressed patients significantly differed by time. x2 ¼ 9.470,df ¼1p < 0.005. (CI: -15.03, - 3.66). Overall viral suppression rateincreased from 69% in 2010 to 85% in 2011.Interpretation: Findings suggest that multi-faceted interventionsincluding identification of caregivers, remedial classes in treatmentpreparation for caregivers, and counseling and support in both clin-ical and community settings are required to improve suppressionrates for pediatric patients.Funding: PEPFAR.Abstract #: 2.023_MDGTobacco use and secondhand smoke exposure amongwomen in Aleta Wondo, Ethiopia: A cross-sectional studyA.B. Petersen1,2, L.M. Thompson1, J.K. Cataldo1; 1University ofCalifornia-San Francisco, San Francisco, CA, USA, 2Loma LindaUniversity, Loma Linda, CA, USABackground: In Ethiopia, female smoking rates are currently low(<1%). However, because male smoking rates are higher (up to27% depending on region), women and children’s risk of secondhand smoke (SHS) exposure is a pressing concern. In order todevelop effective public health interventions that prevent the uptakeand exposure to smoking, thereby averting the projected increase intobacco-induced disease, an understanding of Ethiopian women’spractices regarding tobacco is needed. The purpose of this studywas to describe Ethiopian women’s tobacco use, prevalence ofSHS exposure, and covariates associated with SHS exposure.Methods: We conducted a cross-sectional study in SouthernEthiopia between August and October 2014, and systematicallysampled households in Aleta Wondo town and surroundingdistricts. Interviewers verbally administered surveys to women (18-55 years old). Descriptive statistics and multiple logistic regressionwere performed.Findings: None of the 353 participants reported current tobacco use,and only 0.8% reported that they had ever used tobacco. Twenty-seven women (7.6%) reported living with a tobacco user, however,twice that number (14.4%) reported that smoking occurred dailyinside their home. Living with a tobacco user (OR ¼ 9.68, 95% CI[3.31, 28.32]), absence of a home smoking ban (OR ¼ 6.11, 95%CI [2.82, 13.25]), urbanicity (OR ¼ 3.36, 95% CI [1.52, 7.44)]),and exposure to point-of-sale advertising within the last 30 days(OR¼ 2.66, 95%CI [1.21, 5.83]) contributed significantly to a modelpredicting the likelihood of daily exposure to household SHS.Interpretation: Few women reported having ever used tobacco.However, one in seven women in this study were exposed to house-hold air pollution from SHS; this is a health concern for women andchildren in this rural community. A low level of social acceptabilityof female tobacco use and high levels of tobacco-related stigma mayhave led to underreporting of tobacco use and SHS exposure.A n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6 MDGs and SDGsM a yeJ u n e 2 0 1 6 : 5 1 1 – 5 3 1521Findings from this study provide baseline data for monitoringtobacco control policies in Ethiopia, particularly in relation to thepromotion of smoke-free homes, and could be used to informprogram development.Funding: Sigma Theta Tau International Nursing Honor Society(Alpha Eta & Gamma Alpha Chapters).Abstract #: 2.025_MDGLinkage to care, early infant diagnosis and perinataltransmission among infants born to HIV-infected mothers:Evidence from the baby shower trialJ.R. Pharr1,2, M.C. Obiefune3, C.O. Ezeanolue2, A. Osuji3,A.G. Ogidi3, A.T. Hunt1,2, D. Patel1,2, W. Yang4, G. Ogedegbe5,J.E. Ehiri6, E.E. Ezeanolue1,2; 1Global Health and ImplementationResearch Initiatives, School of Community Health Sciences, Universityof Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV,USA, 1-(702)-895-2687, 2HealthySunrise Foundation, 8752 CastleRidge Avenue, Las Vegas, NV 89129, 3Prevention, Education,Treatment, Training and Research-Global Solutions-PeTR-GS, Plot25 Liberty Estate, Independence Layout Enugu, 400001, Enugu State,Nigeria, 4School of Community Health Sciences, University of Nevada,Reno, MS-274, RM212, Lombardi Recreation Center, Reno, NV89557, 5Center for Healthful Behavior Change, New York UniversityLangone Medical Center, 550 1st Ave, New York, NY, USA,6Department of Health Promotion Sciences, Mel and Enid ZuckermanCollege of Public Health, University of Arizona, 1295 N. Martin Ave.,Tucson, AZ 85724, USABackground: Nigeria accounted for 25% of all new childhoodHIV infections that occurred among the twenty-one priority coun-tries in 2013. Additionally, Nigeria has one of the lowest rates ofearly infant diagnosis (EID) for HIV at only 4%, and only 12%of children living with HIV received antiretroviral therapy (ART).Alternative and complimentary interventions are needed to realizethe Nigerian government’s goals of: at least 80% of all HIV-exposedinfants having access to ART prophylaxis and EID services by 2015.Healthy Beginning Initiative (HBI), a culturally-adapted, family-centered congregation-based approach to HIV testing and linkageto care was developed as an intervention to reduce MTCT ofHIV. The purpose of this study is to report the impact of HBIon ARV prophylaxis, EID, HIV status and linkage to care (ART)among infants born to HIV-infected mothers in SoutheasternNigeria. Additionally, we will report our thoughts on how usingcomponents of implementation science (IS) throughout the processimpacted the intervention.Results: Seventy-three babies were born to the 72 HIV-infectedmothers. Sixty-nine percent of the infants received ARV prophylaxisand 72% completed EID. Six of the infants who did not completeEID had a rapid HIV test. Seven percent of the infants wereHIV-infected. Seventy-five percent of the HIV-infected infantswere on ART. We believe involving the church community in theimplementation process and as implementers, was critical to thesuccess of HBI.Interpretation: By utilizing the components of IS as characterizedby The Alliance, HBI was able to increase participation along thecontinuum of care for PMTCT of HIV with increased ARTprophylaxis and EID for exposed infants and ART therapy ofHIV-infected infants.Funding: The research was co-funded by the Eunice KennedyShriver National Institute of Child Health and Human Develop-ment (NICHD), the National Institute of Mental Health(NIMH), the President’s Emergency Plan for AIDS Relief (PEP-FAR) under award number R01HD075050 to E. E. Ezeanolue.Abstract #: 2.026_MDGWhat are the factors effecting utilisation of antenatal andpostnatal care services according to mothers and health careworkers in the Pwani region, Tanzania?Sanam Qasemzahi; The Liverpool Tropical School of Medicine, Mer-seyside, United KingdomBackground: In 2014, 289,000 women died in developing coun-tries from causes related to pregnancy and childbirth. Over 60%of these deaths occurred in sub-Saharan Africa, most commonlydue to treatable causes such as haemorrhage, hypertensive disordersand obstructed labour. Antenatal care (ANC) and postnatal care(PNC) have been identified as important measures to combatmaternal mortality. In Tanzania, only 43% of women attend thefour recommended ANC-visits and less than half attend a PNC-visit within two days of birth. As there is a shift from the Millen-nium Development Goals (MDG), the Tanzanian governmenthave encouraged research in this area.Methods: The research was done in Pwani across three districtsto explore mothers’ and health care workers (HCW’s) views. Aqualitative and deductive design was adopted. Focus group discus-sions (n¼16) and semi-structured interviews were undertakenwith mothers (n¼14, all females) and HCW’s (n¼10). Non-probability purposive and convenience sampling was used. TheDistrict Medical Officers alongside the research team recruitedparticipants until saturation was achieved. The interviews weretranslated and transcribed before manual thematic analysis andcoding was done. Ethical approval was given by Tanzania andUK.Findings: No participants attended visits at the recommendedtime as a result of being uneducated by HCW’s on the correcttiming or in an attempt to limit the number of visits to avoidtravel-expenses. The visits are free of charge however costs fortransport, equipment, drugs and bribery rendered the services unaf-fordable to some women, mothers reported. The most recurrentfactor leading to non-utilisation of care was resource-scarcity,making it difficult for HCW’s to perform even simple tasks effec-tively. The facilities would also suffer staff-shortage and lack furthertraining opportunities resulting in demotivation and negative atti-tudes in HCW’s.Interpretation: The results may be attributed to the governmentbeing unable to cope with the demands that come with a freematernal healthcare policy. In order to address these problems andachieve the MDGs of universal reproductive care and lowermaternal mortality, the Tanzanian government need to consider

Tobacco use and secondhand smoke exposure among women in Aleta Wondo, Ethiopia: A cross-sectional study

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Tobacco use and secondhand smoke exposure among women in Aleta Wondo, Ethiopia: A cross-sectional study

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