title: Evaluating the benefits of incorporating traditional birth attendants in HIV prevention of mother to child transmission service delivery in Lilongwe, Malawi.
abstract: The objective of our intervention was to examine the benefits of incorporating traditional birth attendants (TBA) in HIV Prevention of Mother to Child Transmission (PMTCT) service delivery. We developed a training curriculum for TBAs related to PMTCT and current TBA roles in Malawi. Fourteen TBAs and seven TBA assistants serving 4 urban health centre catchment areas were assessed, trained and supervised. Focus group discussions with the TBAs were conducted after implementation of the program. From March 2008 to August 2009, a total of 4017 pregnant women visited TBAs, out of which 2133 (53.1%) were directly referred to health facilities and 1,884 (46.9%) women delivered at TBAs and subsequently referred. 168 HIV positive women were identified by TBAs. Of these, 86/168 (51.2%) women received nevirapine and 46/168 (27.4%) HIV exposed infants received nevirapine. The challenges in providing PMTCT services included lack of transportation for referrals and absence of a reporting system to confirm the woman's arrival at the health center. Non-disclosure of HIV status by patients to the TBAs resulted in inability to assist nevirapine uptake. TBAs, when trained and well-supervised, can supplement efforts to provide PMTCT services in communities.
authors.forename: Gloria
authors.initials: G
authors.lastname: Hamela
authors.forename: Charity
authors.initials: C
authors.lastname: Kabondo
authors.forename: Tapiwa
authors.initials: T
authors.lastname: Tembo
authors.forename: Chifundo
authors.initials: C
authors.lastname: Zimba
authors.forename: Esmie
authors.initials: E
authors.lastname: Kamanga
authors.forename: Innocent
authors.initials: I
authors.lastname: Mofolo
authors.forename: Bertha
authors.initials: B
authors.lastname: Bulla
authors.forename: Christopher
authors.initials: C
authors.lastname: Sellers
authors.forename: R C
authors.initials: RC
authors.lastname: Nakanga
authors.forename: Clara
authors.initials: C
authors.lastname: Lee
authors.forename: Francis
authors.initials: F
authors.lastname: Martinson
authors.forename: Irving
authors.initials: I
authors.lastname: Hoffman
authors.forename: Charles
authors.initials: C
authors.lastname: van der Horst
authors.forename: Mina C
authors.initials: MC
authors.lastname: Hosseinipour
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D008880:Midwifery; D019829:Nevirapine / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D024382:Professional Role
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine