马拉维布兰太尔地区预防艾滋病毒母婴传播服务中男性参与策略评估
Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi.
机构信息
Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi;
Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi.
出版信息
Glob Health Action. 2013 Dec 16;6:22780. doi: 10.3402/gha.v6i0.22780.
BACKGROUND
Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT.
OBJECTIVE
The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi.
STUDY DESIGN
An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face-to-face key informant interviews (KIIs) with healthcare workers and four focus group discussions (FGDs) with 18 men and 17 pregnant women attending ANC at SLHC. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analyzed using thematic content analysis.
RESULTS
Three major themes with several subcategories emerged. Theme 1 was a gatekeeping strategy with two subcategories: (1) healthcare workers refusing service provision to women accessing antenatal clinic without their partners and (2) women refusing ANC attention in the absence of a partner. Theme 2 comprised extending invitations and had six subcategories: (1) word of mouth, (2) card invites, (3) woman's health passport book invites, (4) telephonic invites, (5) use of influential people, and (6) home visits. Theme 3 was information education and communication, such as health education forums and advertisements. Of all the strategies, an invitation card addressed to the male partner was most preferred by study participants.
CONCLUSIONS
There are several strategies by which men may be involved in PMTCT. Healthcare workers should offer a pregnant woman all strategies available for MI for her to select the appropriate one. Further research and consultations with men should continue to achieve higher levels of MI.
背景
尽管已有文献证明预防母婴传播（PMTCT）人类免疫缺陷病毒（HIV）服务的益处，但在撒哈拉以南非洲，该服务的利用率仍然很低。缺乏男性参与（MI）可能是其中一个原因。然而，关于 MI 在 PMTCT 中的策略的数据有限。
目的
本研究的目的是确定在马拉维布兰太尔的产前护理（ANC）服务中促进 PMTCT 服务中 MI 的策略。
研究设计
这是一项探索性定性研究，于 2012 年 12 月至 2013 年 1 月在马拉维布兰太尔的南伦祖健康中心（SLHC）进行。它包括对六名医疗保健工作者进行面对面的关键知情者访谈（KII）和与在 SLHC 接受 ANC 的 18 名男性和 17 名孕妇进行的四次焦点小组讨论（FGD）。FGD 根据性别和年龄进行划分。所有 FGD 和 KII 都进行了数字记录，并逐字逐句地同时转录和翻译成英文。使用主题内容分析法对数据进行分析。
结果
出现了三个主题和几个子主题。主题 1 是一种把关策略，有两个子主题：（1）医疗保健工作者拒绝为没有伴侣的妇女提供服务，（2）妇女在没有伴侣的情况下拒绝 ANC 关注。主题 2 包括邀请策略，有六个子主题：（1）口口相传，（2）卡片邀请，（3）妇女健康护照书邀请，（4）电话邀请，（5）利用有影响力的人，（6）家访。主题 3 是信息教育和沟通，例如健康教育论坛和广告。在所有策略中，研究参与者最倾向于向男性伴侣发送的邀请卡。
结论
有几种策略可以让男性参与 PMTCT。医疗保健工作者应为孕妇提供所有可用的 MI 策略，让她选择合适的策略。应继续进行进一步的研究和与男性的协商，以实现更高水平的 MI。
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