LEVEL OF AWARENESS ON THE PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES AMONG PREGNANT WOMEN IN CALABAR MUNICIPALITY OF CROSS RIVER STATE
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1.1 Background of the study
Human immunodeficiency virus infection and AIDS are leading causes of morbidity and mortality amongst women and children, particularly in the sub-Saharan African countries where the prevalence of HIV is high. Globally, in 2009, 370 000 children under 15 years of age were newly infected by HIV and an estimated 42 000–60 000 pregnant women died as result of HIV. Over 90% of the paediatric infections occurred through mother to child infection. Twenty low and middle income countries, including Nigeria, account for the highest estimated numbers of pregnant women living with HIV. In contrast, the number of new HIV infections amongst children and HIV-related deaths in mothers and children is virtually zero in high-income countries as a result of access to timely preventive services (UNAIDS, 2011)
Nigeria has the second highest number of people living with HIV in the world after South Africa, with an estimated 2.98 million people living with HIV, which constitutes nine per cent of the global HIV burden (FMOH, 2008). Women are disproportionately more affected than men, accounting for 58% of the national HIV burden. The prevalence of HIV is highest amongst women aged between 20 and 29 years and this situation has implications for the transmission of HIV from mothers to children (UNGASS, 2010). Various factors contribute to the high burden of paediatric HIV infection in Nigeria and other sub-Saharan African countries. These include the high prevalence of HIV infection amongst women of reproductive age, large populations of women, high birth rates, and lack of access to effective interventions aimed at preventing mother to child transmission of HIV (Abiodun, 2013). Infants born to HIV-positive mothers in developing countries are at a 30–45% risk of being infected during pregnancy, delivery and breastfeeding in the absence of intervention to prevent mother to child infection (Dabis, Leroy and Castebonk, 2012). However, the rates of Mother to Child Transmission (MTCT) of HIV have fallen to as low as 2% in the developed countries with the introduction of the Prevention of Mother to Child (PMTCT) programmes (Abiodun, 2013). The services provided include HIV counselling and testing (HCT) for HIV in antenatal clinics and maternity wards, antiretroviral drug therapy, comprehensive antenatal care and safer delivery practices, appropriate infant feeding, counselling and support. The Nigerian PMTCT programme commenced in July 2012 with the goals of providing effective PMTCT services for women in the reproductive age group in selected health facilities and generating information for the formulation of a national policy and implementation guidelines for a comprehensive PMTCT intervention in Nigeria. There are currently several hundred sites providing these services in the six geo-political zones of Nigeria, under the coordination of the Federal Ministry of Health (Adewole, Oluwole, Sagay, 2016).