Factors affecting retention in care of women receiving elimination of mother to child transmission of HIV services at Mbarara regional referral hospital

Abstract

Background: While Elimination of Mother to Child Transmission (EMTCT) of HIV program has been an important strategy in preventing HIV infections in infants from mothers, retention of expectant women in care remains a challenge yet, factors affecting retention of women in care so as they are able to continue receiving EMTCT services are not documented. This study therefore was an attempt to explore factors affecting retention in care of women receiving Elimination of Mother to Child Transmission of HIV (EMTCT) services at Mbarara Regional Referral Hospital, Mbarara District. Methodology: Relying on Mbarara Regional Referral Hospital to study individual mothers receiving EMCT services, a qualitative study approach was used. A total of fifteen women receiving EMCT services were interviewed using an in-depth interview guide. All mothers were selected from the hospital. In addition, I conducted a total of three key informant interviews with two nurses and the doctor in charge while using a key informant interview guide. I supplemented the information with a review of hospital documents to gain some additional insights. All the evidence gathered were analysed following the qualitative thematic data analysis steps proposed by Braun and Clark.2012. Themes were originally based on the study objectives but also other key emerging themes were identified through a rigorous analysis process. Findings: In interviews with women on EMTCT program, they mentioned that it is very difficult for them to easily come to the health facility due to high transport costs which has led to low retention of mothers at the health facility. They also revealed that due the fact that the EMTCT buildings are labelled, mothers feel to be stigmatized when seen going there for treatment. Therefore, findings revealed that stigma, discrimination, high transportation costs and gender inequalities are factors that affect retention of women in care receiving EMTCT services at Mbarara Regional Referral Hospital. Conclusion: Women in care receiving EMTCT services at the health facility have tried to use the available services and retain in care however there are socio-economic and institutional factors that still affect mothers from utilizing the existing services and this has resulted into low retention of mothers receiving EMTCT services at the hospital. The hospital should carryout partnerships and linkages especially with existing HIV mother support groups which help to strengthen retention of women in care and utilization of available EMTCT services at the health facility. Key words: EMTCT, MTCT, Retention in care, HIV/AIDS