Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda.
<h4>Background</h4>Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Tran...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2022-01-01
|
Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0275905 |
_version_ | 1797828031529615360 |
---|---|
author | Rebecca Akunzirwe Sabrina Bakeera-Kitaka Joan N Kalyango Jane Frances Zalwango Judith Amutuhaire Ssemasaazi Tom Okello Remmy Buhuguru Sarah Kiguli Aloysius G Mubuuke Sam Ononge |
author_facet | Rebecca Akunzirwe Sabrina Bakeera-Kitaka Joan N Kalyango Jane Frances Zalwango Judith Amutuhaire Ssemasaazi Tom Okello Remmy Buhuguru Sarah Kiguli Aloysius G Mubuuke Sam Ononge |
author_sort | Rebecca Akunzirwe |
collection | DOAJ |
description | <h4>Background</h4>Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of HIV services. Some low-resource countries with poor utilization of health care services have piloted G-ANC. However, there is limited evidence of its efficiency. We, therefore, compared G-ANC versus F-ANC with regards to optimal utilization of PMTCT of HIV services and assessed associated factors thereof among adolescent mothers in eastern Uganda. We defined optimal utilization of PMTCT of HIV services as the adolescent being up to date with HIV counseling and testing. If found HIV negative, subsequent timely re-testing. If found HIV positive, initiation of antiretroviral therapy (ART) under option B plus for the mother. While for the infant, it entailed safe delivery, testing, feeding, and appropriate HIV chemotherapy.<h4>Methods</h4>From February to April 2020, we conducted a cross-sectional study among 528 adolescent mothers in four sites in eastern Uganda. We assessed the optimal utilization of PMTCT of HIV services among adolescent mothers that had attended G-ANC versus F-ANC at the post-natal care or immunization clinics. We also assessed the factors associated with optimal utilization of PMTCT of HIV services among these mothers.<h4>Results</h4>Optimal utilization of PMTCT was higher among those in G-ANC than in F-ANC (74.7% vs 41.2, p-0.0162). There was a statistically significant association between having attended G-ANC and optimal utilization of PMTCT [PR = 1.080, 95%CI (1.067-1.093)]. Other factors independently associated with optimal utilization were; having a partner that tested for HIV [PR = 1.075, 95%CI (1.048-1.103)], trimester of first ANC visit: second trimester [PR = 0.929, 95%CI (0.902-0.957)] and third trimester [PR = 0.725, 95%CI (0.616-0.853)], and the health facility attended: Bugembe HCIV [PR = 1.126, 95%CI (1.113-1.139)] and Jinja regional referral hospital [PR = 0.851, 95%CI (0.841-0.861].<h4>Conclusions</h4>Adolescent mothers under G-ANC had significantly higher optimal utilization of PMTCT of HIV services compared to those under F-ANC. We recommend that the Ministry of Health considers widely implementing G-ANC, especially for adolescent mothers. |
first_indexed | 2024-04-09T12:57:57Z |
format | Article |
id | doaj.art-32c008f5e0bf447eb0efdd01ffe501a0 |
institution | Directory Open Access Journal |
issn | 1932-6203 |
language | English |
last_indexed | 2024-04-09T12:57:57Z |
publishDate | 2022-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLoS ONE |
spelling | doaj.art-32c008f5e0bf447eb0efdd01ffe501a02023-05-13T05:31:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711e027590510.1371/journal.pone.0275905Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda.Rebecca AkunzirweSabrina Bakeera-KitakaJoan N KalyangoJane Frances ZalwangoJudith Amutuhaire SsemasaaziTom OkelloRemmy BuhuguruSarah KiguliAloysius G MubuukeSam Ononge<h4>Background</h4>Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of HIV services. Some low-resource countries with poor utilization of health care services have piloted G-ANC. However, there is limited evidence of its efficiency. We, therefore, compared G-ANC versus F-ANC with regards to optimal utilization of PMTCT of HIV services and assessed associated factors thereof among adolescent mothers in eastern Uganda. We defined optimal utilization of PMTCT of HIV services as the adolescent being up to date with HIV counseling and testing. If found HIV negative, subsequent timely re-testing. If found HIV positive, initiation of antiretroviral therapy (ART) under option B plus for the mother. While for the infant, it entailed safe delivery, testing, feeding, and appropriate HIV chemotherapy.<h4>Methods</h4>From February to April 2020, we conducted a cross-sectional study among 528 adolescent mothers in four sites in eastern Uganda. We assessed the optimal utilization of PMTCT of HIV services among adolescent mothers that had attended G-ANC versus F-ANC at the post-natal care or immunization clinics. We also assessed the factors associated with optimal utilization of PMTCT of HIV services among these mothers.<h4>Results</h4>Optimal utilization of PMTCT was higher among those in G-ANC than in F-ANC (74.7% vs 41.2, p-0.0162). There was a statistically significant association between having attended G-ANC and optimal utilization of PMTCT [PR = 1.080, 95%CI (1.067-1.093)]. Other factors independently associated with optimal utilization were; having a partner that tested for HIV [PR = 1.075, 95%CI (1.048-1.103)], trimester of first ANC visit: second trimester [PR = 0.929, 95%CI (0.902-0.957)] and third trimester [PR = 0.725, 95%CI (0.616-0.853)], and the health facility attended: Bugembe HCIV [PR = 1.126, 95%CI (1.113-1.139)] and Jinja regional referral hospital [PR = 0.851, 95%CI (0.841-0.861].<h4>Conclusions</h4>Adolescent mothers under G-ANC had significantly higher optimal utilization of PMTCT of HIV services compared to those under F-ANC. We recommend that the Ministry of Health considers widely implementing G-ANC, especially for adolescent mothers.https://doi.org/10.1371/journal.pone.0275905 |
spellingShingle | Rebecca Akunzirwe Sabrina Bakeera-Kitaka Joan N Kalyango Jane Frances Zalwango Judith Amutuhaire Ssemasaazi Tom Okello Remmy Buhuguru Sarah Kiguli Aloysius G Mubuuke Sam Ononge Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda. PLoS ONE |
title | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda. |
title_full | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda. |
title_fullStr | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda. |
title_full_unstemmed | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda. |
title_short | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda. |
title_sort | optimal utilization of prevention of mother to child transmission of hiv services among adolescents under group versus focused antenatal care in eastern uganda |
url | https://doi.org/10.1371/journal.pone.0275905 |
work_keys_str_mv | AT rebeccaakunzirwe optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT sabrinabakeerakitaka optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT joannkalyango optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT janefranceszalwango optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT judithamutuhairessemasaazi optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT tomokello optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT remmybuhuguru optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT sarahkiguli optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT aloysiusgmubuuke optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT samononge optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda |