Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

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

(
• List common problems affecting access and utilization of HIV/AIDS care services (
• Describe key elements to community collaborative approaches in improving the quality of maternal and child health services (
• Evaluate the current role of governments in providing access to care, treatment and preventive services to vulnerable populations and communities.

Keywords: Access and Services, Vulnerable Populations

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

Presenting author's disclosure statement:

Not Answered