Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Private Bag X5400, DurbanDurban, 4000, South Africa.
BMC Health Serv Res. 2022 Aug 3;22(1):988. doi: 10.1186/s12913-022-08382-8.
Nigeria has the second largest HIV epidemic in the world and is one of the countries with the highest rates of new pediatric infections in sub-Saharan Africa. The country faces several challenges in the provision of healthcare services and coverage of Prevention of Mother to child transmission of HIV. In the Nigeria's Department of Defense, prevention of vertically transmitted HIV infections has been given a boost by utilizing Mentor Mothers to facilitate antiretroviral compliance and retention in care. The aim of this study was to explore those processes and policies that guide the implementation of the Mentor Mothers program for PMTCT of HIV in the Department of Defense in Nigeria as no studies have examined this so far.
The descriptive, qualitative research approach was utilized. We conducted 7 key informants interviews with 7 purposively selected participants made up of 2 program Directors, 1 Doctor, 1 PMTCT focal Nurse, 1 PMTCT site coordinator, 1 Mentor Mother, and 1 patient from one each of the health facilities of the Army, Navy, Airforce and the Defence Headquarters Medical Centre. Open coding for major themes and sub-themes was done. Data were analyzed using thematic analysis.
Findings revealed that the program in the Department of Defense had been modelled after the WHO and implementing partners' guidelines. Foundational Factors; Leadership; Skill acquisition; and Service Characteristics emerged as processes guiding the implementation of the Mentor-Mothers program in the DoD. These findings supported the Mentor Mother Model, which empowers mothers living with HIV - through education and employment - to promote access to essential PMTCT services and medical care to HIV positive pregnant women.
We concluded that no definitive policy establishes the Mentor Mothers program in the DoD. Working with Doctors, Nurses, local & collaborating partners, and communities in which these hospitals are located, the Mentor Mothers play a pivotal role in the formation, facilitation, and implementation of the MM model to effectively decrease HIV infections in children and reduce child and maternal mortality in women and families they interact with.
尼日利亚是世界上第二大艾滋病毒流行地区,也是撒哈拉以南非洲新发生儿童感染率最高的国家之一。该国在提供医疗保健服务和覆盖预防艾滋病毒母婴传播方面面临着一些挑战。在尼日利亚国防部,利用导师母亲来促进抗逆转录病毒的遵守和保持护理,推动了预防垂直传播艾滋病毒感染的工作。本研究的目的是探讨指导尼日利亚国防部实施导师母亲母婴传播艾滋病毒预防方案的过程和政策,因为迄今为止尚无研究对此进行过考察。
采用描述性定性研究方法。我们对 7 名经刻意挑选的参与者进行了 7 次关键知情者访谈,他们包括 2 名方案主任、1 名医生、1 名 PMTCT 重点护士、1 名 PMTCT 地点协调员、1 名导师母亲和来自陆军、海军、空军和国防总部医疗中心的每一个卫生机构的 1 名患者。对主要主题和子主题进行开放式编码。使用主题分析对数据进行分析。
调查结果显示,该方案是在世界卫生组织和执行伙伴的指导方针基础上在国防部实施的。基础因素;领导;技能获取;以及服务特征是指导国防部实施导师母亲方案的过程。这些发现支持了导师母亲模式,该模式通过教育和就业赋予艾滋病毒感染者母亲权力,以促进获得基本的母婴传播预防服务和艾滋病毒阳性孕妇的医疗保健。
我们的结论是,国防部没有明确的政策来确定导师母亲方案。导师母亲与医生、护士、当地和合作伙伴以及这些医院所在的社区合作,在 MM 模式的形成、促进和实施中发挥着关键作用,以有效减少儿童中的艾滋病毒感染,并降低她们所接触的妇女和家庭中的儿童和孕产妇死亡率。