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PhD Student, KwaZulu-Natal

PINBOARD SUMMARY

At the moment there is no universally agreed scale for measuring male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV. At the same time, previous studies have found that the participation of male partners in PMTCT interventions is very low yet men play a crucial role in the prevention of HIV. Also, male partners influence women's access, utilization and adherence to PMTCT interventions. However, previous studies have found that male partner involvement in antenatal and post natal care centers has been low. The scales that have been used to measure male partner involvement vary according to context.
The present research was motivated by the need to monitor and evaluate to what extent male partners are taking part in PMTCT interventions carried out in a rural district in Zimbabwe. Using a Statistical Package for Social Sciences (SPSS), an various analysis were done so as to come with items that qualify to be retained in the scale. A total of seven variables was finally retained in the final analysis: These are: Man discussed HIV testing with partner Man disclosed HIV status to partner Man counselled on infant feeding Man counselled on HIV prevention during pregnancy Man accompanied partner to ANC Man accompanied partner for polymerase chain reaction Man tested for HIV during previous pregnancy

Using this index, levels of male partner participation among the 7 items ranged from 86.2% to 94.4%. The item; male partner attendance at antenatal care had the highest score. The index builds upon other indices that have been previously developed to measure male partner involvement. It also captures crucial activities within PMTCT programmes from pregnancy to delivery which some of the previous scales did not consider. It is in such activities that male partners are expected to participate in preventing pediatric HIV.

3 ITEMS PINNED

Official invitation letters to promote male partner attendance and couple voluntary HIV counselling and testing in antenatal care: an implementation study in Mbeya Region, Tanzania.

Abstract: The benefits of male partner involvement in antenatal care (ANC) and prevention of mother-to-child transmission of HIV (PMTCT) for maternal and infant health outcomes have been well recognised. However, in many sub-Saharan African settings, male involvement in these services remains low. Previous research has suggested written invitation letters as a way to promote male partner involvement.In this implementation study conducted at three study sites in southwest Tanzania, acceptability of written invitation letters for male partners was assessed. Pre-study CVCT rates of 2-19 % had been recorded at the study sites. Pregnant women approaching ANC without a male partner were given an official letter, inviting the partner to attend a joint ANC and couple voluntary counselling and testing (CVCT) session. Partner attendance was recorded at subsequent antenatal visits, and the invitation was repeated if the partner did not attend. Analysis of socio-demographic indices associated with male partner attendance at ANC was also performed.Out of 318 women who received an invitation letter for their partner, 53.5 % returned with their partners for a joint ANC session; of these, 81 % proceeded to CVCT. Self-reported HIV-positive status at baseline was negatively associated with partner return (p = 0.033). Male attendance varied significantly between the rural and urban study sites (p < 0.001) with rates as high as 76 % at the rural site compared to 31 % at the urban health centre. The majority of women assessed the joint ANC session as a favourable experience, however 7 (75 %) of women in HIV-positive discordant or concordant relationships reported problems during mutual disclosure. Beneficial outcomes reported one month after the session included improved client- provider relationship, improved intra-couple communication and enhanced sexual and reproductive health decision-making.Official invitation letters are a feasible intervention in a resource limited sub-Saharan African context, they are highly accepted by couple members, and are an effective way to encourage men to attend ANC and CVCT. Pre-intervention CVCT rates were improved in all sites. However, urban settings might require extra emphasis to reach high rates of partner attendance compared to smaller rural health centres.

Pub.: 17 Oct '15, Pinned: 25 Aug '17

Impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV on the uptake of PMTCT services in sub-Saharan Africa: a protocol of a systematic review and meta-analysis.

Abstract: Several studies have reported approaches used in improving the delivery of prevention of mother-to-child transmission (PMTCT) of HIV services through the involvement of male partners, but evidence from a systematic review is limited. We aim at determining the impact of male partner involvement on PMTCT in sub-Saharan Africa.This will be a systematic review of published literature. Interventional and observational studies on male involvement in PMTCT carried out in sub-Saharan Africa will be included irrespective of the year and language of publication. OVID Medline, Embase, PschINFO, and Cochrane database of controlled trials will be searched. After manual searching of articles, authors shall be contacted for further information. 2 authors (NFT and CJ) will independently screen potential articles for eligibility using defined inclusion and exclusion criteria. Critical Appraisal Skills Programme (CASP) tools, Jadad scale and the STROBE checklist will be used for critical appraisal, and the 2 authors will independently assess the quality of articles. Authors will independently extract data from studies using a pre-established data collection form, and any discrepancies will be sorted by a third author (TRK). Outcomes will be analysed using STATA V.12.0. The random effect model will be used to produce forest plots. The heterogeneity χ(2) statistics and I(2) will be used to assess for heterogeneity. Publication bias will be assessed using funnel plots. This protocol is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines.No ethical approval since included studies will be published studies that had already obtained ethical approvals. The findings will guide HIV programmes on the best approaches towards involving male partners in PMTCT with a view to improving PMTCT services in sub-Saharan Africa.42016032673.

Pub.: 03 Jul '16, Pinned: 25 Aug '17

Strategies to improve male involvement in PMTCT Option B+ in four African countries: a qualitative rapid appraisal.

Abstract: Background The World Health Organization recommends that antiretroviral therapy be started as soon as possible, irrespective of stage of HIV infection. This 'test and treat' approach highlights the need to ensure that men are involved in prevention of mother-to-child HIV transmission (PMTCT). This article presents findings from a rapid appraisal of strategies to increase male partner involvement in PMTCT services in Uganda, Democratic Republic of Congo, Malawi, and Côte d'Ivoire in the context of scale-up of Option B+ protocol. Design Data were collected through qualitative rapid appraisal using focus groups and individual interviews during field visits to the four countries. Interviews were conducted in the capital city with Ministry of Health staff and implementing partners (IPs) and at district level with district management teams, facility-based health workers and community health cadres in each country. Results Common strategies were adopted across the countries to effect social change and engender greater participation of men in maternal, child and women's health, and PMTCT services. Community-based strategies included engagement of community leaders through dialogue and social mobilization, involving community health workers and the creation and strengthening of male peer cadres. Facility-based strategies included provision of incentives such as shorter waiting time, facilitating access for men by altering clinic hours, and creation of family support groups. Conclusions The approaches implemented at both community and facility levels were tailored to the local context, taking into account cultural norms and geographic regional variations. Although intentions behind such strategies aim to have positive impacts on families, unintended negative consequences do occur, and these need to be addressed and strategies adapted. A consistent definition of 'male involvement' in PMTCT services and a framework of indicators would be helpful to capture the impact of strategies on cultural and behavioral shifts. National policies around male involvement would be beneficial to streamline approaches across IPs and ensure wide-scale implementation, to achieve significant improvements in family health outcomes.

Pub.: 06 Feb '17, Pinned: 25 Aug '17