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APHA Scientific Session and Event Listing

Improving HIV/AIDS Care and Support Systems at a Maternity Hospital in Kenya

Jessy Devieux, PhD1, Julliette Onyancha, MPH2, Nisha Farrell, BA1, and Robert Malow, PhD1. (1) AIDS Prevention Program, Florida International University, 3000 NE 151 Street, Miami, FL 33181, 305-919-4200, devieuxj@fiu.edu, (2) Robert Stempel School of Public Health/AIDS Prevention Program, Florida International University, 3000 N.E. 151st Street, North Miami, FL 33181

Background: Pumwani Maternity Hospital, the largest regional referral center in Nairobi for low-income obstetric cases, suffers from resource constraints (e.g. < 80 nurses) and service overloads (e.g., >70 deliveries/day). Thus, STI/HIV services (e.g., VCT/PMTCT) have been neglected. This qualitative study obtained input from stakeholders (e.g., clients, staff) to help determine factors influencing the utilization of and accessibility to these needed services.

Methods: Data was obtained from one structured group interview with 6 hospital staff members and 3 focus groups with a total of 33 reproductive age women clients and 9 youths. Discussions elicited information on participants' perceptions of factors limiting the utilization and access to services.

Results: Results indicate access to care was influenced by community misperceptions about HIV transmission, discriminatory attitudes towards persons living with HIV, difficulty navigating service systems, and poor working conditions for staff. A lack of ARVs and replacement foods was found, and a follow-up program to assist mothers the first 6 months after delivery was non-existent. Locations of VCT/PMTCT centers were not easily accessible to the population.

Conclusions: Stigma surrounding HIV/AIDS is pervasive and many respondents had no confidence in assurances of confidentiality regarding HIV testing. For education programs to be effective, misconceptions, high-risk behaviors, stigma surrounding AIDS and confidentiality of HIV testing would need to be addressed. Governments and communities would benefit from working together to improve community-based health care facilities and support systems for vulnerable populations as well as the substandard conditions faced by expecting women and the workers that care for them.

Learning Objectives: Participants will be able to

Keywords: Access and Services, Vulnerable Populations

Related Web page: www.popcouncil.org/ebert/wellbriefing.html#e

Presenting author's disclosure statement:

Not Answered

Topics in HIV/AIDS II

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA