Top

BMC Pregnancy and Childbirth

Published in:

Open Access 01-12-2021 | Human Immunodeficiency Virus | Research

A multilevel analysis of determinants of PMTCT service utilisation among women during the antepartum, intrapartum and postpartum period in Ethiopia

Authors: Tsegaye Gebremedhin, Tesfa Sewunet Alamneh, Asebe Hagos, Beimnet Desalegn, Nigusu Worku

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

Mother-to-child transmission (MTCT) is the largest source of HIV infection in children below the age of 15 years, and more than 90% of pediatric HIV are infected through mother to child transmission. Without treatment, one-half of those infected children will die before the age of 2 years. Despite this, there is limited evidence on PMTCT and its determinants. Therefore, this study aimed to determine the factors affecting the PMTCT service utilisation in Ethiopia.

Methods

A two-stage stratified sampling technique was used to identify 4081 women from 2016 Ethiopian Demographic and Health Survey (EDHS). A multilevel mixed-effect binary logistic regression analysis was used to identify the individual and community level factors associated with PMTCT services utilisation. In the final model, a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) were used to declare statistically significant factors with the utilisation.

Results

Overall, 21.9% (95% CI, 20.6–23.2) of the women were utilized PMTCT services. Educational status; primary (AOR: 1.65, 95% CI: 1.27–2.13), secondary (AOR: 1.52, 95% CI: 1.03–2.24) and higher school (AOR: 2.48, 95% CI: 1.45–4.22), poorer (AOR: 1.62, 95% CI: 1.12–2.37), middle (AOR: 1.82, 95% CI: 1.10–3.02), richer (AOR: 2.44, 95% CI: 1.42–4.21) and richest (AOR: 4.45, 95% CI: 2.43–8.14) wealth status and orthodox religion follower (AOR: 1.62, 95% CI: 1.22–2.16) were the individual level factors. Moreover, having basic (AOR: 1.66, 95% CI: 1.34–2.06) and comprehensive (AOR: 1.73, 95% CI: 1.38–2.18) knowledge on HIV prevention methods, having knowledge on MTCT of HIV (AOR: 2.69, 95% CI: 2.16–3.36) were also factors at individual level. Whereas, rural residence (AOR: 0.52, 95% CI: 0.32–0.85) was the community level factors that affects the utilization.

Conclusions

Less than one-fourth of the mothers had utilised the PMTCT services in Ethiopia. To increase the utilisation of the services, the health care providers should give emphases on counselling, awareness creation, and strengthen the existing frontline integrated health care services in the country.

HIV/AIDS UJUNPo: Ending the aids epidemic by 2030 aspart of the sustainable development goals. 2016.

Organization WH: Ethiopia HIV country profile. 2016 https://www.who.int/hiv/data/Country_profile_Ethiopia.pdf?ua=1

UNAIDS. Prevention of HIV transmission from mother to child: strategic options; 1999.

Frontieres MS. Prevention of mother-to-child transmission (PMTCT) of HIV: protocol; 2017.

Kellerman SE, Sugandhi N. Pediatric AIDS in the elimination agenda. PLoS Med. 2013;10(8):e1001503. https://doi.org/10.1371/journal.pmed.1001503.CrossRefPubMedPubMedCentral

Organization WH: PMTCT strategic vision 2010–2015 : preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals. 2010.

UNAIDS. Prevention gap report; 2016.

Moges NA, Kassa GM, Boneya DJ. Rate of HIV transmission and associated factors among HIV-exposed infants in selected health facilities of east and west Gojjam zones, Northwest Ethiopia; retrospective cohort study. BMC Infect Dis. 2017;17(1):475. https://doi.org/10.1186/s12879-017-2578-3.CrossRefPubMedPubMedCentral

Organization WH: Guideline on WHENTO START antiretroviral therapy and on pre-exposure prophylaxis for HIV. 2015.

10.

UNAIDS JUNPoHA: 2015 Progress report on the golobal plan towards the elimination of new HIV infections among children and keeping their mothers alive. 2015.

11.

Kassa GM. Mother-to-child transmission of HIV infection and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis. 2018;18(1):216. https://doi.org/10.1186/s12879-018-3126-5.CrossRefPubMedPubMedCentral

12.

Akal CG, Afework DT. Status of prevention of mother-to-child transmission (PMTCT) services utilization and factors affecting PMTCT service uptake by pregnant women attending antenatal Care Clinic in Selected Health Facilities of Afar regional state. Ethiopia J Environ Public Health. 2018;2018:5127090.PubMed

13.

Deressa W, Seme A, Asefa A, Teshome G, Enqusellassie F. Utilization of PMTCT services and associated factors among pregnant women attending antenatal clinics in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2014;14(1):328. https://doi.org/10.1186/1471-2393-14-328.CrossRefPubMedPubMedCentral

14.

Feleke BE, Wasie B. Challenges of PMTCT service utilization in Amhara region: a comparative cross-sectional study. Ethiop J Health Sci. 2018;28(6):779–86. https://doi.org/10.4314/ejhs.v28i6.13.CrossRefPubMedPubMedCentral

15.

Worldometer. Ethiopia Demographics of December 10, 2020. https://www.worldometers.info/demographics/ethiopia-demographics/.

16.

Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia demographic and health survey 2016. Addis Ababa and Rockville: CSA and ICF; 2016. https://dhsprogram.com. In.; 2016

17.

Linguissi LSG, Sagna T, Soubeiga ST, Gwom LC, Nkenfou CN, Obiri-Yeboah D, et al. Prevention of mother-to-child transmission (PMTCT) of HIV: a review of the achievements and challenges in Burkina-Faso. HIV/AIDS (Auckland, NZ). 2019;11:165.

18.

Hox JJ, Kreft IG. Multilevel analysis methods. Sociological Methods & Research. 1994;22(3):283–99.

19.

Van Duijn MA, Van Busschbach JT, Snijders TA. Multilevel analysis of personal networks as dependent variables. Social Networks. 1999;21(2):187–210.

20.

Agresti A, Booth JG, Hobert JP, Caffo B. Random‐effects modeling of categorical response data. Sociological Methodology. 2000;30(1):27–80.

21.

Deressa W. Utilization of PMTCT services and associated factor among pregnant women attending antenatal clinic in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2014;14(1). https://doi.org/10.1186/1471-2393-14-328.

22.

CSA-Ethiopia I: International: Ethiopia Demographic and Health Survey 2011. Central Statistical Agency of Ethiopia and ICF International Addis Ababa, Ethiopia and Calverton, Maryland, USA 2012.

23.

Megersa G, Tariku N, Belay Y, Adeba T, Daniel W, Fufa B, et al. Utilization of Prevention of Mother to Child transmission (PMTCT) services and factors that affect knowledge and service uptake among pregnant women attending antenatal care in East Hararge Zone of Oromia Reginal State. Ethiopian Journal of Health Development. 2014;28(Special Issue):26–35.

24.

Fana A, Debela M, Giref AZ, Gebreyesus SH, Yirtaw TG, Bahaga ST, et al. PMTCT service utilization and associated factors among pregnant women attending public health facilities in Hawassa City, southern Ethiopia. Ethiopian J Reprod Health (EJRH). 2019;11:16.

25.

Afework2 CGAaDT. Status of prevention of mother-to-child transmission (PMTCT) services utilization and factors affecting PMTCT service uptake by pregnant women attending antenatal Care Clinic in Selected Health Facilities of Afar regional state, Ethiopia. Hindawi J Environ Public Health. 2018:7. https://doi.org/10.1155/2018/5127090.

26.

Mustapha M, Musiime V, Bakeera-Kitaka S, Rujumba J, Nabukeera-Barungi N. Utilization of “prevention of mother-tochild transmission” of HIV services by adolescent and young mothers in Mulago hospital, Uganda. BMC Infect Dis. 2018. https://doi.org/10.1186/s12879-018-3480-3.

27.

Amare Y, Degefie T, Mulligan B. Newborn care seeking practices in central and southern Ethiopia and implications for community based programming; 2015.

28.

Elias Asfaw Zegeye, Josue Mbonigaba and Zacharie Tsala Dimbuene: Factors associated with the utilization of antenatal care and prevention of motherto-child HIV transmission services in Ethiopia: applying a count regression mode. https://doi.org/10.1186/s12905-018-0679-9.

29.

Ndonga E, Matu M. Factors affecting uptake of prevention of mother to child transmission of HIV by women attending antenatal clinic in Pumwani maternity hospital, Nairobi, Kenya. MOJ Public Health. 2019;8(3):90–6.

30.

Hailu D, Nigussie W, Gudeta TA, Abdu M, Molla Y, Assefaw G. Assessment of knowledge and attitude towards prevention of mother-to child transmission of HIV/AIDS among antenatal care client in Mizan-Aman town public health facilities, Benchi-Maji Zone, South Nation Nationalities and People Region, Southwest Ethiopia, 2017. Clinics Mother Child Health. 2018;15(280):2.

Title: A multilevel analysis of determinants of PMTCT service utilisation among women during the antepartum, intrapartum and postpartum period in Ethiopia
Authors: Tsegaye Gebremedhin
Tesfa Sewunet Alamneh
Asebe Hagos
Beimnet Desalegn
Nigusu Worku
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Human Immunodeficiency Virus
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-03896-1

2024 ASCO Annual Meeting

Springer Medicine

A multilevel analysis of determinants of PMTCT service utilisation among women during the antepartum, intrapartum and postpartum period in Ethiopia

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries

The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis

Effect of amino acid infusion during cesarean delivery on newborn temperature: a randomized controlled trial

Fetal growth restriction as the initial finding of preeclampsia is a clinical predictor of maternal and neonatal prognoses: a single-center retrospective study

Factors associated with birthweight decline in Japan (1980–2004)

Maternal alcohol use, adverse neonatal outcomes and pregnancy complications in British Columbia, Canada: a population-based study