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    Jan 16, 2021
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    HIV care need not hamper maternity care: a descriptive analysis of integration of services in rural Malawi

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    Name:
    van Akker HIV care need not ...
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    Authors
    van den Akker, T
    Bemelmans, M
    Ford, N
    Jemu, M
    Diggle, E
    Scheffer, S
    Zulu, I
    Akesson, A
    Shea, J
    Affiliation
    Thyolo District Health Office, Ministry of Health, Thyolo, Malawi; Médecins Sans Frontières, Thyolo Project, Thyolo, Malawi; Child Health Unit, University of Cape Town, Cape Town, South Africa; Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Médecins Sans Frontières, Geneva, Switzerland; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
    Issue Date
    2012-01-18
    
    Metadata
    Show full item record
    Journal
    BJOG: An International Journal of Obstetrics and Gynaecology
    Abstract
    Please cite this paper as: van den Akker T, Bemelmans M, Ford N, Jemu M, Diggle E, Scheffer S, Zulu I, Akesson A, Shea J. HIV care need not hamper maternity care: a descriptive analysis of integration of services in rural Malawi. BJOG 2012;119:431-438. Objective  To evaluate the use of reproductive health care and incidence of paediatric HIV infection during the expansion of antiretroviral therapy and services for the prevention of mother-to-child transmission in rural Malawi, and the influence of integration of these HIV-related services into general health services. Design  Descriptive analysis. Setting  Thyolo District, with a population of 600 000, an HIV prevalence of 21% and a total fertility rate of 5.7 in 2004. Population  Women attending reproductive health services care in 2005 and 2010. Methods  Review of facility records and databases for routine monitoring. Main outcome measures  Use of antenatal, intrapartum, postpartum, family planning and sexually transmitted infection services; incidence of HIV infection in infants born to mothers who received prevention of mother-to-child transmission care. Results  There was a marked increase in the uptake of perinatal care: pregnant women in 2010 were 50% more likely to attend at least one antenatal visit (RR 1.50, 95% CI 1.48-1.51); were twice as likely to deliver at a healthcare facility (RR 2.05, 95% CI 2.01-2.08); and were more than four times as likely to present for postpartum care (RR 4.40, 95% CI 4.25-4.55). Family planning consultations increased by 40% and the number of women receiving treatment for sexually transmitted infections doubled. Between 2007 and 2010, the number of HIV-exposed infants who underwent testing for HIV went up from 421 to 1599/year, and the proportion testing positive decreased from 13.3 to 5.0%; infants were 62% less likely to test HIV positive (RR 0.38, 95% CI 0.27-0.52). Conclusions  During the expansion and integration of HIV care, the use of reproductive health services increased and the outcomes of infants born to HIV-infected mothers improved. HIV care may be successfully integrated into broader reproductive health services.
    Publisher
    Wiley-Blackwell
    URI
    http://hdl.handle.net/10144/255368
    DOI
    10.1111/j.1471-0528.2011.03229.x
    PubMed ID
    22251303
    Additional Links
    http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2011.03229.x/abstract
    Type
    Article
    Language
    en
    Description
    Article approval pending
    ISSN
    1471-0528
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1471-0528.2011.03229.x
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

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