Barriers to maternal retention in HIV care in Ghana: key differences during pregnancy and the postpartum period.

BMC Pregnancy and Childbirth
Kwame S SakyiPamela J Surkan

Abstract

Maternal retention in HIV care is lower for women in the postpartum period than during pregnancy, but the reasons are poorly understood. We examined key differences in barriers to retention in HIV care during and after pregnancy. We conducted semi-structured, in-depth interviews with 30 postpartum women living with HIV. Participants were recruited from two tertiary facilities implementing Option B+ for prevention of mother-to-child HIV transmission in Accra, Ghana. We collected data from mothers who had disengaged from HIV care and those who were still engaged in care. The interviews were analyzed using principles adapted from grounded theory. Participants' experiences and narratives showed that retention in HIV care was more challenging during the postpartum period than during pregnancy. Poor maternal physical health (from birth complications and cesarean section), socio-cultural factors (norms about newborn health and pregnancy), and economic difficulties linked to childbirth (such as unemployment, under-employment, and debt) made the costs of retention in HIV care more economically and socially expensive in the postpartum period than during pregnancy. Some participants also shared that transportation costs and resulting depe...Continue Reading

References

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Dec 2, 2010·Annals of Tropical Paediatrics·E OkyereZ Hill
Sep 23, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Michael J MugaveroMichael S Saag
Feb 5, 2013·Tropical Medicine & International Health : TM & IH·Kate ClouseMatthew P Fox
Jul 1, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Kate ClouseAudrey Pettifor
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Methods Mentioned

BETA
cesarean section
cesarean sections

Software Mentioned

Atlas
ti

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