Horizons Projects | Evaluating the Effect of Stigma-reduction Interventions on PMTCT Providers and Clients

HORIZONS PROJECT
Evaluating the Effect of Stigma-reduction Interventions on PMTCT Providers and Clients

Although a great number of health facilities in Kenya offer prevention of mother-to-child HIV transmission (PMTCT) services, uptake at many sites remains low. Some of the challenges that have been cited are shortages of human resources, poor infrastructure (e.g., lack of enough space to provide confidential services), poor obstetric care and infection control practices, periodic shortages of HIV testing kits, and low utilization of PMTCT services owing to stigma among health workers and the general population.

Horizons and Tulane University are collaborating on a study (formally titled "A Targeted Evaluation of the Effect of Health Facility Stigma-reduction Interventions on PMTCT Provider Attitudes and Uptake of PMTCT Services") that addresses this last issue. The study is examining whether stigma-reducing interventions change provider attitudes and increase demand and uptake of PMTCT services in 40 health facilities in two provinces in Kenya with high HIV prevalence. AMKENI is managing the interventions, which involve a series of activities and educational seminars aimed at health personnel. The interventions are based on EngenderHealth’s curriculum, “Reducing stigma and discrimination related to HIV and AIDS training for health care workers,” and include an adaptation of the PLHA-friendly hospitals checklist developed by Horizons for a pilot study in India.

The intervention will be evaluated using a pre- and post-test, quasi-experimental design that includes interviews with health providers and clients, and by continuous monitoring using routine service statistics compiled by AMKENI. The main outcomes will be provider attitudes and utilization of PMTCT services by women. These will be supplemented by qualitative data from providers and clients on perceptions of PMTCT services.

Location

Coast and Western Provinces, Kenya

Duration

July 2005–April 2007

Horizons and Population Council researchers

Naomi Rutenberg, Julie Pulerwitz, Susan Cherop-Kaai

Non-Council collaborators

Kate Macintyre (Tulane University)

Linda Archer, Anjala Kanesathasan, Joel Rakwar (AMKENI)

EngenderHealth

Donor

US Agency for International Development

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