Interactions among poverty, gender, and health systems affect women's participation in services to prevent HIV transmission from mother to child: A causal loop analysis

PloS One
Jennifer YourkavitchJames C Thomas

Abstract

Retention in care remains an important issue for prevention of mother-to-child transmission (PMTCT) programs according to WHO guidelines, formerly called the "Option B+" approach. The objective of this study was to examine how poverty, gender, and health system factors interact to influence women's participation in PMTCT services. We used qualitative research, literature, and hypothesized variable connections to diagram causes and effects in causal loop models. We found that many factors, including antiretroviral therapy (ART) use, service design and quality, stigma, disclosure, spouse/partner influence, decision-making autonomy, and knowledge about PMTCT, influence psychosocial health, which in turn affects women's participation in PMTCT services. Thus, interventions to improve psychosocial health need to address many factors to be successful. We also found that the design of PMTCT services, a modifiable factor, is important because it affects several other factors. We identified 66 feedback loops that may contribute to policy resistance-that is, a policy's failure to have its intended effect. Our findings point to the need for a multipronged intervention to encourage women's continued participation in PMTCT services and for l...Continue Reading

References

Dec 4, 2004·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Carey FarquharGrace C John-Stewart
Feb 2, 2006·American Journal of Public Health·John D Sterman
Feb 2, 2006·American Journal of Public Health·Jack B Homer, Gary B Hirsch
May 20, 2008·Transactions of the Royal Society of Tropical Medicine and Hygiene·L D BwirireE J Schouten
Jun 16, 2009·Reproductive Health Matters·Jacqueline Rose ChinkondeFrancis Martinson
Apr 16, 2013·Lancet·Scott KellermanJonathan D Quick
Jul 1, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Kate ClouseAudrey Pettifor
Aug 5, 2014·Tropical Medicine & International Health : TM & IH·Hannock TweyaSam Phiri
Dec 9, 2015·Journal of the International AIDS Society·Rebecca MathesonAditi Sharma

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Citations

Apr 24, 2020·AIDS Patient Care and STDs·Angela M ParcesepeBatya Elul
Dec 19, 2019·Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention·Rebecca B NaumannKristen Hassmiller Lich
Jun 10, 2020·Bulletin of the World Health Organization·Stephanie Watson-GrantJames Thomas

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