Accessing Barriers and Determinants of Prevention of Mother to Child Transmission (PMTCT) of Human Immune Deficiency Virus (HIV) Services at Public Teaching Hospitals in Enugu State, Nigeria

Abstract

Introduction: The most effective means of reducing Mother-to-Child transmission of HIV is to provide suppressive HAART. Prevention of Mother to Child Transmission (PMTCT) directly affects the achievement of Sustainable Development goals just. The unmet need for PMTCT services in Nigeria, particularly in Enugu state, is unacceptably high. This study aimed to assess factors associated with access barriers and determinants to PMTCT services in public health facilities in Enugu, Nigeria. Materials and Methods: The study design was a facility-based analytical cross-sectional study. HIV positive nursing mothers who were accessing PMTCT services were studied. Questionnaire was used. Chi-square test and Binary logistic regression was done to for determinants of experience of any access barrier.  Level of significance was determined at a p-value of ≤ 0.05. Results: A total of 2275 participants were reported on. A higher proportion of participants were in 30-34 years age group 124 (45.1%), attained secondary education 144(52.4%) and provided for by their husbands 174(63.3%) The major barriers identified were; long waiting time at the facility 184(66.9%), distance of facility 161(58.5%), PMTCT being far away from other units/departments 155(56.4%), Health workers talking to the clients with no respect 151(54.9%), Stigma and discrimination from friends/neighbours 163(59.3%) and from health workers 123(44.7%) as well as being too busy with household chores 130(47.3%). There were statistically significant association between experience of barriers with age in categories (χ2=11.741, p =0.008), religion (χ2=5.381, p =0.020), source of income (χ2= 8.817, p=0.032) and ethnicity (χ2=9.240, p=0.026). Conclusion: Over ninety percent of respondents experienced a form of barrier. The major barriers include; long waiting time, distance to facility, location of PMTCT units, Health workers attitude, Stigma and discrimination from health workers as well as being too busy with household chores. There was no identified predictor of access barrier.