KNOWLEDGE, ATTITUDE AND PRACTICE OF HEALTHCARE PROVIDERS ON PMTCT OF HIV IN BAMENDA HEALTH DISTRICT

Derick Ngwa Awambeng (dawambeng@yahoo.com)
Obstetrics and Gynecology, The University of Yaounde I
July, 2015
 

Abstract


In most developed countries HIV testing, the correct use of antiretroviral drugs (ARVs), enhance delivery practices and correct infant feeding options have greatly reduced the rate of mother to child transmission (MTCT) of HIV-1 but this is not yet the case in many African countries. In Cameroon, prevention of mother to child transmission (PMTCT) services has been introduced in nearly all health institutions. Proper implementation of these services requires adequate knowledge, right attitudes and practices (KAPs) on the part of the healthcare providers.


The main objective of this study was to assess the KAPs of healthcare providers on PMTCT in the Bamenda Health District (BHD).


It was a KAP survey conducted between December 1st and May 16th. Healthcare providers (Doctors and paramedical personnel) involve in the PMTCT cascade in the Bamenda Regional Hospital and six other health facilities in the BHD constitute our study population. Using a questionnaire, information was obtained on knowledge, attitudes and practices regarding PMTCT of HIV, entered in to Epi Info 17.0 and analysed using Statistical Package for Social Sciences (SPSS). P. values< 0.05 was considered statistically significant


Knowledge on PMTCT was moderate with mean composite scores within 65-85% range. None knew the prevalence of HIV in pregnancy and 32% didn’t know of the risk of transmission during pregnancy. Also although 70% could name more than three risk factors during breastfeeding, 72.9% didn’t think the viral strain (HIV1) is a factor. 78% knew the current drug regimen, 93% knew the ARV prophylaxis for exposed babies and 93% when to initiate ARV. 94% knew there were national guidelines while 84% the current treatment option in Cameroon. 96% knew couples could be discordant. Older and university trained providers were more likely to have better knowledge. Attitudes towards PMTCT were good. Most providers (87%) were willing to care for HIV positive mothers and didn’t think they should have a special unit of their own. However some (49%) were scared of occupational infection, 67% felt they needed to be motivated for the extra work involve in PMTCT while 53% would screen pregnant women even without their consent. Practice of providers on PMTCT was mostly inadequate with a positive correlation with attitudes. Over 83% offering counselling and testing, 94% offering infant feeding and counselling and over 70% providing more than one contraceptive option. 45% would use double gloves always with HIV positive parturient, 70% were offering safer obstetric practices. Nurses and Midwives made up 81.3% of those offering PMTCT in BHD.


The study showed that knowledge was moderate with no statistical significance with attitude (P=0.5035), and practice (P=0.1114). Their attitudes were good towards PMTCT with an insignificant positive correlation between attitudes and practice (Pearson correlation, r=0.09783) practice was mostly inadequate. Continuing medical education will help improve on these gaps. Healthcare providers offering PMTCT in the BH D are mostly nurses and midwives, and a significant number have not been trained on PMTCT of HIV.
words: knowledge. Attitudes. Practices. Prevention. Mother-child. Transmission HIV.>


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