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Implementation of repeat HIV testing during pregnancy in Kenya: a qualitative study
Anna Joy Rogers1, Elly Weke2, Zachary Kwena2
1Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, Birmingham, USA. rogersaj@uab.edu.
BMC Pregnancy and Childbirth
|July 13, 2016
Summary
Repeat HIV testing during pregnancy in Kenya is crucial for preventing mother-to-child transmission but faces low implementation. Addressing client, provider, facility, and system barriers is key to improving HIV testing rates.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Services Research
Background:
- Repeat human immunodeficiency virus (HIV) testing in late pregnancy aims to reduce mother-to-child transmission by detecting seroconversion after initial negative tests.
- Despite being national policy in Kenya, the implementation rates of repeat HIV testing for pregnant women remain low.
Purpose of the Study:
- To explore barriers and enablers to implementing repeat HIV testing guidelines for pregnant women in Kenya.
- To identify factors influencing the uptake and provision of repeat HIV testing within antenatal care services.
Main Methods:
- Conducted 20 in-depth semi-structured interviews with healthcare providers and managers in Kenya's Nyanza region.
- Utilized thematic analysis of interview transcripts, applying Ferlie and Shortell's Framework for Change and emergent themes.
Main Results:
- Barriers identified at client (late presentation, low antenatal visit completion), provider (workload, forgetfulness), facility (client volume, space), and health system (supply chain, register design) levels.
- Enablers included word-of-mouth, provider cooperation, task shifting, and potential electronic health record system reminders.
Conclusions:
- Significant barriers impede the implementation of repeat HIV testing guidelines for pregnant women in Kenya.
- A multi-faceted intervention addressing identified barriers and leveraging enablers is essential for successful guideline implementation and reducing HIV transmission.
