Community-based Approaches to Preventing Mother-to-Child Transmission of HIV
Council researchers examined the effectiveness of three community-based strategies in increasing women’s utilization of key PMTCT services in Kibera, an urban slum of Nairobi, Kenya.
The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an operations research study to compare three different community-based approaches in Kibera, a densely settled urban slum in Nairobi, Kenya, and to analyze the cost-effectiveness of each in increasing women’s use of services to prevent mother-to-child transmission of HIV (PMTCT). The strategies included (1) moving PMTCT services closer to the population via a mobile clinic, and increasing psychosocial support for HIV-positive women through the use of (2) traditional birth attendants and (3) peer counselors. All three approaches were supported by health information campaigns to increase public knowledge about vertical HIV transmission, promote PMTCT services, and reduce stigma and discrimination.
The effectiveness of these strategies were measured by comparing baseline to follow-up, cross-sectional data. At baseline (2004), the researchers conducted exit interviews with women ten weeks' or less postpartum.
Banner photo: Manoocher Deghati/IRIN
Findings from the baseline data about family planning include:
- HIV-positive women are significantly more likely than HIV-negative women to say that they do not intend to have more children.
- Many women had not discussed family planning with a provider during antenatal care.
- Providers give directive counseling for HIV-positive women, that is, they encourage use of family planning and discourage having more children.
- Postpartum family planning use is similar for HIV-positive and HIV-negative women.
- Most HIV-positive and HIV-negative women intend to use contraceptives in the future and view several methods favorably.
- Multiple factors influence how HIV-positive women decide to use family planning.
- Women identified side effects as a major reason to not use family planning.
- Although being HIV-positive inhibits partner communication, the vast majority of HIV-positive women felt they could talk about HIV and family planning with their partner.
Key findings on infant feeding counseling and practice include:
- Many women do not receive infant feeding counseling; however, HIV-positive women were more likely to have received infant feeding counseling than HIV-negative women or women of unknown HIV status.
- HIV-positive women were more likely to have practiced exclusive breastfeeding and reported higher levels of MTCT transmission knowledge; they were less likely to have practiced mixed feeding than their counterparts.
Banner photo: Manoocher Deghati/IRIN
Community-based approaches to prevention of mother-to-child transmission of HIV: Findings from a low-income community in Kenya (PDF)
Kaai,Susan; Baek,Carolyn; Geibel,Scott; Omondi,Peter; Ulo,Benson; Muthumbi,Grace; Nkatha,Carol; Rutenberg,Naomi
Horizons Final Report
Publication date: 2007
Project Stats
Location: Kenya (Kibera slum and Dagoretti, Nairobi)
Program(s):
HIV and AIDS
Topic(s):
Access to contraceptive methods
HIV care, support, and treatment
PMTCT and pediatric HIV
Duration: 5/2004 - 4/2007
Population Council researchers:
Scott Geibel
Naomi Rutenberg
Non-Council collaborators:
Barbara Janowitz (Family Health International)
Carol N'Katha-Matiko (Steadman Research Services International)
Centers for Disease Control and Prevention
Peter McOdida (International Medical Corps)
Ulo Benson (International Medical Corps)
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