A Critical Investigation of the Prevention of Mother to Child Transmission of Hiv (PMTCT) Programme and Its Effects on Maternal and Child Health at Aloba General Hospital, Oyo State
Chapter One
Objective Of Study
The following are objectives of this study:
- To examine the mode of HIV transmission from mother to child.
- To examine how HIV transmission affects maternal and child health.
- To investigate the preventive measures for mother to child transmission of HIV.
CHAPTER TWO
REVIEW OF LITERATURE
INTRODUCTION
Our focus in this chapter is to critically examine relevant literature that would assist in explaining the research problem and furthermore recognize the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps.
Precisely, the chapter will be considered in three sub-headings:
- Conceptual Framework
- Theoretical Framework
- Empirical framework
CONCEPTUAL FRAMEWORK
Concept of HIV/ AIDS
AIDS means Acquired Immune Deficiency Syndrome (National AIDS control programme, 1990; Miller, Briggs & Corcoran, 1997; Wayne, 1993). It is an acquired condition, which means that it is not hereditary. It makes the immune system unable to defend the body against infections and diseases. AIDS is also a syndrome, which is a term for a group of symptoms. Federal Ministry of Health (2003) defined a syndrome as a set of symptoms that together are indicative of a condition, for example AIDS. Cohen et al (1994) defined AIDS as the late stage of Human Immunodeficiency Virus (HIV) infection. Onuzulike (1998) defined HIV as the virus that destroys parts of the white blood cells, which are the bodies disease fighting immune system. Olumide (2002) defined AIDS as a disease caused by human immunodeficiency virus. He further conceptualized AIDS as the end stage manifestation of a long-standing, on going infection with human immunodeficiency virus. Adeoye (2004) stated that AIDS applies to the most advanced stages of HIV infection, while Onwuekwe (2005) stated that AIDS is a full blown disease of the human immunodeficiency virus. Cohen et al (1994) reported that AIDS is a term conceptualized by the Centre for Disease Control (CDC) in 1982, to create a case definition of the syndrome characterized by acquired immunodeficiency and its complications. He also reported that in 1987 the CDC further defined AIDS as the endpoint in clinical research on progression of HIV disease and also as criteria for case reporting that helps quantify the growth of the epidemic of HIV infection. Ugwuegbulam (2004) opined that AIDS is the stage of HIV infection, when one is highly susceptible to infections, which the natural immune system would ordinarily combat and defeat. AIDS depresses the immune system that usually protects the body against invasion of pathogens like bacteria and fungi. Cohen et al (1994) stated that AIDS begins with transmission of HIV, establishment of infection and an initial host immune system response that temporarily controls clinical manifestations of disease. It is a chronic progressive process that begins, when the human immunodeficiency virus enters the blood stream of the afflicted person and progresses over a period of more than ten years as the virus replicates in lymphoid tissue, relatively destroying the host immune system and progression is often accelerated in infants with perinatal HIV infection. During this time, the host becomes increasingly susceptible to opportunistic infections, which are infections the body will ordinarily combat and defeat and eventually dies from complications of these opportunistic infections and malignancies resulting from immune system dysfunction (Cohen et al., 1994). Olumide (2002) stated that the time between infection with the HIV and on set of the disease AIDS is variable and ranges from six months to ten years or more. Onuzulike (1998) stated that HIV and AIDS infection may take as many as ten years or more before an infected person actually begins to have symptoms of the disease. According to her, by this time, the infected person who appears to be healthy may have passed on the disease to others. Olumide (2002) stated that patients with AIDS usually die from opportunistic infections with cough and diarrhea; central nervous system disease or wasting, less commonly from malignancy. Onuzulike (1998) opined that the HIV destroys the immune system slowly. AIDS infection has different stages (Cohen et al., 1994). At the primary stage of the disease, an infected person might look apparently healthy for over ten years, depending on his or her level of body immunity. Onuzulike (1998) stated that once the HIV gets into the human body, it gradually adapts by fusing itself into a replica human white blood cell, thereby destroying its potency and replace it. Gradually, the AIDS virus will finally subdue the body’s immune system. CDC (1990) stated that when HIV destroys the potency of the white blood cell, the body’s defence against diseases falls and will be rendered incapable of fighting off diseases. At this full blown stage of the development, the host is exposed to common wasting diseases like diarrhea, and fever. He or she gets very sick and may later die after a very excruciating sickness.
Olumide (2002) stated that during infection with AIDS, CD4 + T-lymphocytes, as well as other cells of the immune system, are affected and depleted leaving the patient progressively immuno-compromised. As the CD 4 +T – lymphocyte count decreases, patients are at increased risk of a wide variety of infections, inflammatory conditions and malignancies. In 1982, the Centre for Disease Control (CDC) in the United States of America listed conditions and infections that are associated with the serious immune deficiency caused by HIV infection and defined them as Acquired Immune Deficiency Syndrome (AIDS). This case definition was designed primarily for epidemiological surveillance. Adeoye (2004) explained that the CDC definition of AIDS include all HIV infected people, who have fewer than 200 CD 4 positive T cells (CD 4 + T cells) per cubic millimeter of blood (healthy adults usually have CD 4 positive T cells counts of 1000 or more).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
In this chapter, we described the research procedure for this study. A research methodology is a research process adopted or employed to systematically and scientifically present the results of a study to the research audience viz. a vis, the study beneficiaries.
Research Design
Research designs are perceived to be an overall strategy adopted by the researcher whereby different components of the study are integrated in a logical manner to effectively address a research problem. In this study, the researcher employed the survey research design. This is due to the nature of the study whereby the opinion and views of people are sampled. According to Singleton & Straits, (2009), Survey research can use quantitative research strategies (e.g., using questionnaires with numerically rated items), qualitative research strategies (e.g., using open-ended questions), or both strategies (i.e. mixed methods). As it is often used to describe and explore human behaviour, surveys are therefore frequently used in social and psychological research.
Population of the Study
According to Udoyen (2019), a study population is a group of elements or individuals, as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitutes individuals or elements that are homogeneous in description.
This study was carried out to examine the prevention of mother to child transmission of HIV (PMTCT) programme and its effects on maternal and child health at Aloba General Hospital, Oyo State. Hence, the population of this study comprises of women at Aloba General Hospital, Oyo State.
Sample Size Determination
A study sample is simply a systematic selected part of a population that infers its result on the population. In essence, it is that part of a whole that represents the whole and its members share characteristics in like similitude (Udoyen, 2019). In this study, the researcher adopted the convenient sampling method to determine the sample size.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
Introduction
This chapter presents the analysis of data derived through the questionnaire and key informant interview administered on the respondents in the study area. The analysis and interpretation were derived from the findings of the study. The data analysis depicts the simple frequency and percentage of the respondents as well as interpretation of the information gathered. A total of one hundred and forty-seven (147) questionnaires were administered to respondents of which only one hundred and forty-one (141) were returned and validated. This was due to irregular, incomplete and inappropriate responses to some questionnaire. For this study a total of 141 was validated for the analysis.
CHAPTER FIVE
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS:
Introduction
This chapter summarizes the findings on the prevention of mother to child transmission of HIV (PMTCT) programme and its effects on maternal and child health at Aloba General Hospital, Oyo State. The chapter consists of summary of the study, conclusions, and recommendations.
Summary of the Study
In this study, our focus was to assess the prevention of mother to child transmission of HIV (PMTCT) programme and its effects on maternal and child health at Aloba General Hospital, Oyo State. The study specifically was aimed to examine the mode of HIV transmission from mother to child, examine how HIV transmission affects maternal and child health, and investigate the preventive measures for mother to child transmission of HIV.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondents are women at Aloba General Hospital, Oyo State.
Conclusions
Based on the findings of this study, the researcher made the following conclusion.
- The mode of HIV transmission from mother to child include; pregnancy, during childbirth and breastfeeding.
- HIV transmission affects the maternal health of child bearing women.
- HIV transmission affects child’s health.
- The possible preventive strategies for mother to child transmission of HIV are; creating public awareness, educating people on HIV, providing appropriate treatment, care, and support to mothers living with HIV, and avoiding breastfeeding.
- PMTCT plays a significant role in promoting maternal and child health.
Recommendations
Based on the findings of the study, the following recommendations are proffered.
- There is need for the involvement of the stakeholders in bridging the gap between knowledge and utilization of PMTCT services among women.
- A revised health education programme for pregnant women living with HIV should be implemented to enlighten women and mean on the need to utilize PMTCT services.
- Health personnel should always encourage husbands of women living with HIV to utilize PMTCT services to prevent mother to child transmission of the virus.
- Health personnel should avoid discrimination of women living with HIV and to show them positive attitude to that will encourage them to continue to utilize PMTCT services.
- The government should provide PMTCT centres in rural areas so as to provide access to PMTCT facilities to all, especially among women resident in rural areas. This will serve as an encouragement to rural pregnant women to utilize the PMTCT services.
- Government should implement the policy on penalizing those discriminating and stigmatizing people women living with HIV. This will encourage women to utilize PMTCT services without fear of discriminating and stigmatizing.
- Infant feeding counseling needs to be improved and access to portable water for formular feeding should be made available.
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