Factors affecting utilization of PMTCT services by pregnant women living with HIV in Tanzania: a case study of Kinodnoni Municipal

This dissertation reports the findings on the effectiveness of the Prevention of Mother to Child Transmission (PMTCT) services among HIV pregnant women which was done in Kinondoni Municipality. The study consists of four specific objectives; to understand the individual factors that influence utilization of PMTCT services among pregnant women living with HIV(PWLHIV), community factors which influence utilization of PMTC services among PWLHIV, the health system factors which influence utilization of PMTC services among PWLHIV, and the effectiveness of the current strategies which are used to promote the utilization of PMTCT services among PWLHIV. Using the descriptive research design, data were generated through semi-structured interviews with 44 informants who were purposely selected from the health facilities and one nongovernmental organization supporting the implementation of PMTCT services. The data obtained were subjected to qualitative analysis, which was followed by descriptive report writing. The findings shows that accessibility, utilization and the adherence to PMTCT services at the municipality have been impacted by various factors. The individual factors identified are the attitude of both partners towards PMTCT services, mode of transport, clinic hours, waiting times, financial situation and improvement in clinical condition influenced the utilization of the PMTCT among the majority of the respondents. Non-disclosure of HIV positive status, use of traditional clinics/healers, CD4 count and residential area, communication between pregnant women and their husband/partners, knowledge and attitude towards HIV/AIDS, the disclosure of HIV status to the family, stigma and shame related to stigma do not influence utilization of the services. Community factors, such as family income, level of poverty, values and norms, the influence of traditional healers are positively related to the utilization of the PMTCT among the majority of the respondents. There are few cases in which these factors negatively affected the utilization of PMTCT services. The health system factors includes accessibility to PMTCT services centre, remoteness of the areas, health education provided, HCPs counseling skills and attitudes, HCPs knowledge and experience with PMTCT services, working conditions among HCPs, availability of ARVs, nature of follow up mechanisms which highly contributed to the utilization of the PMTCT services among the respondents. However, there are few cases of dissatisfaction, especially in the area of HCPs, knowledge and the experience on program have has positively influenced the utilization of PMTCT. The current strategies for enhancing PMTCT utilization in Kinondoni Municipality is PMTCT option B+, which has led to such an increase in the number of HIV negative children and identified number of discordant couples. Different challenges facing the program have been identified, among them include inadequate HCPs on the areas of RCH and PMTCT services, lack of disclosure of HIV status among the couples, lack of HIV test before the relationship, lack of disclosure of HIV status to the community. The study concludes that there is a possibility of acquiring zero MTCT in Kinondoni municipality. Following these findings, it is recommended that there is a need to enhance the utilization of the PMTCT services.