Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia.
Midwifery Science Program, Faculty of Medicine, Universitas Pendidikan Ganesha, Bali, 81116, Indonesia.
BMC Public Health. 2024 Aug 20;24(1):2258. doi: 10.1186/s12889-024-19692-3.
This study aimed to explore the facilitators and barriers to the elimination of human immunodeficiency virus (HIV), syphilis, and hepatitis B transmission based on the perspectives of mothers living with HIV, syphilis, and hepatitis B.
This study employed a descriptive, qualitative design. Semi-structured interviews were conducted with mothers living with HIV, syphilis, and/or hepatitis B virus. A total of 25 participants were included in the study. This study used a triangulation method conducted by members to enhance the validity and dependability of the findings. The study was conducted at referral hospitals and community health centers between September 2022 and February 2023. Data analysis utilized deductive content analysis and categorized themes based on a socio-ecological framework.
The findings revealed facilitators and barriers across five levels of the socio-ecological framework and 21 subcategories. The findings included the following: (1) At the policy level, facilitators were mandatory testing programs, and barriers were separating testing services from antenatal care facilities. (2) At the community level, facilitators included the involvement of non-governmental organizations (NGOs) and cross-sector support. Barriers included challenges faced by non-residents and fear of stigma and discrimination. (3) At the healthcare system level, facilitators included tracking and follow-up by midwives, positive relationships with healthcare providers, and satisfaction with healthcare services. Barriers included prolonged waiting times, insufficient information from healthcare providers, and administrative limitations. (4) At the interpersonal level, facilitators included partner and family support, open communication, and absence of stigma. Barriers included the reluctance of sexual partners to undergo screening. (5) At the individual level, facilitators included the desire for a healthy baby, adequate knowledge, self-acceptance, and commitment to a healthy lifestyle; barriers included the lack of administrative discipline.
Mothers living with HIV, syphilis, or hepatitis B require tailored healthcare approaches. Healthcare professionals must understand and meet the needs of mothers within a comprehensive care continuum. The findings of this study advocate for the development and implementation of integrated care models that are responsive to the specific challenges and preferences of affected mothers, aiming to improve health outcomes for both mothers and their children.
本研究旨在基于感染 HIV、梅毒和乙型肝炎的母亲的观点，探讨消除 HIV、梅毒和乙型肝炎传播的促进因素和障碍。
本研究采用描述性定性设计。对感染 HIV、梅毒和/或乙型肝炎病毒的母亲进行半结构式访谈。共有 25 名参与者纳入研究。本研究采用成员三角测量法，以提高研究结果的有效性和可靠性。研究于 2022 年 9 月至 2023 年 2 月在转诊医院和社区卫生中心进行。数据采用演绎内容分析法进行分析，并根据社会生态框架分类主题。
研究结果揭示了社会生态框架五个层次和 21 个子类别的促进因素和障碍。研究结果包括：（1）在政策层面，促进因素是强制性检测方案，障碍是将检测服务与产前保健设施分开。（2）在社区层面，促进因素包括非政府组织（NGO）的参与和跨部门支持，障碍包括非居民面临的挑战以及对耻辱感和歧视的恐惧。（3）在医疗保健系统层面，促进因素包括助产士的跟踪和随访、与医疗保健提供者的积极关系以及对医疗保健服务的满意度，障碍包括等待时间延长、医疗保健提供者提供的信息不足以及行政限制。（4）在人际层面，促进因素包括伴侣和家庭的支持、开放的沟通和没有耻辱感，障碍包括性伴侣不愿意接受筛查。（5）在个人层面，促进因素包括对健康婴儿的渴望、充足的知识、自我接纳和对健康生活方式的承诺，障碍包括缺乏行政纪律。
感染 HIV、梅毒或乙型肝炎的母亲需要量身定制的医疗保健方法。医疗保健专业人员必须在全面的关怀连续体中了解和满足母亲的需求。本研究的结果主张制定和实施综合关怀模式，以响应受影响母亲的特定挑战和偏好，旨在改善母婴的健康结果。
