Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study
Objectives Despite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to i...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e034418.full |
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| author | Michelle Kermode Margaret Kelaher Christina Lumbantoruan Endang Budihastuti |
| author_facet | Michelle Kermode Margaret Kelaher Christina Lumbantoruan Endang Budihastuti |
| author_sort | Michelle Kermode |
| collection | DOAJ |
| description | Objectives Despite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.Design A retrospective cross-sectional study in December 2017.Setting All health facilities providing PMTCT programmes in Indonesia.Participants All health facilities registering at least one woman in antenatal care in 2017.Intervention PMTCT data extraction from the national reporting system on HIV/AIDS and government reports.Outcomes Women retention in the PMTCT programme for at least 3 months and associated health facility characteristics.Results A total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).Conclusions We observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority. |
| format | Article |
| id | doaj-art-326941e5b53745bfb9b6de3f153b6204 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-326941e5b53745bfb9b6de3f153b62042025-01-08T06:05:09ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2019-034418Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional studyMichelle Kermode0Margaret Kelaher1Christina Lumbantoruan2Endang Budihastuti3Nossal Institute for Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, AustraliaCentre for Health Policy, The University of Melbourne, Melbourne, Victoria, AustraliaSub-directorate HIV AIDS and STI, Ministry of Health of the Republic of Indonesia, Jakarta, DKI Jakarta, IndonesiaObjectives Despite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.Design A retrospective cross-sectional study in December 2017.Setting All health facilities providing PMTCT programmes in Indonesia.Participants All health facilities registering at least one woman in antenatal care in 2017.Intervention PMTCT data extraction from the national reporting system on HIV/AIDS and government reports.Outcomes Women retention in the PMTCT programme for at least 3 months and associated health facility characteristics.Results A total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).Conclusions We observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.https://bmjopen.bmj.com/content/10/9/e034418.full |
| spellingShingle | Michelle Kermode Margaret Kelaher Christina Lumbantoruan Endang Budihastuti Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study BMJ Open |
| title | Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study |
| title_full | Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study |
| title_fullStr | Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study |
| title_full_unstemmed | Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study |
| title_short | Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study |
| title_sort | pregnant women s retention and associated health facility characteristics in the prevention of mother to child hiv transmission in indonesia cross sectional study |
| url | https://bmjopen.bmj.com/content/10/9/e034418.full |
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