1. Integrating quality postnatal care into PMTCT in Swaziland.
- Author
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Mazia G, Narayanan I, Warren C, Mahdi M, Chibuye P, Walligo A, Mabuza P, Shongwe R, and Hainsworth M
- Subjects
- Adolescent, Adult, Counseling, Eswatini, Female, HIV-1, Health Knowledge, Attitudes, Practice, Humans, Infant, Newborn, Maternal Health Services statistics & numerical data, Mothers, Observation, Postnatal Care methods, Pregnancy, Pregnancy Complications, Infectious prevention & control, Program Evaluation, Quality Assurance, Health Care, Young Adult, HIV Infections transmission, Health Personnel education, Infectious Disease Transmission, Vertical prevention & control, Maternal Health Services organization & administration, Postnatal Care organization & administration
- Abstract
Swaziland's prevention of mother-to-child transmission (PMTCT) programme is linked to maternal and newborn health (MNH) services, but is mainly focussed on HIV/AIDS. Existing MNH services are inadequate, especially postnatal care (PNC) of mothers and babies, with delayed postnatal visits occurring at 4-6 weeks after delivery. Fifty-seven percent of staff in seven Swazi health facilities were trained in promoting and providing early PNC. A final evaluation showed a 20-fold increase in the number of visits coming for an early postnatal visit (within the first three days after birth). A direct observation of the client-provider interaction showed a significant increase in the competence of the health workers related to postnatal examinations, and care of mothers and babies (p<0.05- < 0.01). The percentage of women breastfeeding within one hour of delivery increased by 41% in HIV-positive mothers and 52% in HIV-negative mothers. Cotrimoxazole prophylaxis for HIV-exposed infants increased by 24%. Although, health workers were observed providing counselling, maternal recall of messages was deficient, suggesting the need for additional strategies for promoting healthy behaviours. High-quality integrated PMTCT programmes and MNH postnatal services are feasible and acceptable, and can result in promoting early postnatal visits and improved care of both HIV-positive and HIV-negative mothers and their babies.
- Published
- 2009
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