Factors associated with missing appointments in the prevention of mother to child transmission of HIV (OPTION B+) program in Njombe town council.

Abstract

Background: Tanzania has adopted the World Health Organization recommendation of initiating lifelong anti-retroviral treatment to all pregnant and lactating mothers infected with human immunodeficiency virus (HIV) regardless of disease immunological or clinical stage with the aim to eliminate mother to child transmission (eMTC) of HIV. Challenges in consistently attending care and treatment services as scheduled have been reported, this study seek to find out whether such factors also affect PMTCT option B+ program. Objective: To determine factors associated with missing appointments in prevention of mother to child transmission of HIV (Option B+) program in Njombe town Council Methods: Descriptive cross-sectional study with a sample size of 196 participants. Interviewed responses were analyzed using SPSS version 20.0. Chi square was performed to determine the association between the independent variables and the dependent variable. Odds ratios were calculated to assess the likelihood of some factors that were found significant. Results: A total number of 196 participants were interviewed of which 37% reported to have been missing clinic since ART initiation. Age group above 35 years had increased risk of missing appointments in the PMTCT clinics (AOR=1.7, 95%CI=0.51-6.07). However, this age group has no statistical significance since 95% CI includes one. Divorced women (AOR=12.2, 95% CI=1.77-85.8), education level secondary school and above (AOR=12.2 95% CI=1.77-83.8), norms and beliefs (AOR=4.1, 95% CI=1.71-9.92), religious beliefs (AOR=4.4, 95% CI= 1.25-15.67), those with little community cooperation (AOR=9.9, 95%CI=1.68-59.0) were more likely to miss PMTCT clinics. Economic factors studied with the exception of lack of road accessibility throughout the year were not associated with missing clinic. Those who experienced lack of privacy (AOR=3.582, 95% CI=1.59-8.06), dissatisfaction (AOR=8.8, 95% CI= 3.07-25.61), spending much time at clinic (AOR=1.8, 95%CI=1.37-8.23) were more likely to miss clinic appointments. Conclusion: More strategies and sustainability measures for improving attendance into PMTCT services in Njombe Town Council like tracking system using home based care services, community health worker for maximum impact in tracing clients’ early need to be revised and improved.