Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities

Preconception care use and associated factors among HIV positive reproductive age women attending ART clinics at public hospitals in the Hadiya zone, southern Ethiopia: a mixed method approach

BACKGROUND

Globally, the HIV pandemic makes preconception care even more crucial due to the additional risks for sexual and vertical transmission of HIV. However, there is limited evidence on the utilization of preconception care among high-risk women in Ethiopia. The purpose of this research is to assess preconception care utilization and associated factors among HIV-positive women of reproductive age who attend ART clinics in public hospitals in the Hadiya zone of Southern Ethiopia in 2023.

METHODS

A cross-sectional study design employing a mixed methods approach was used among 297 study participants from July 1-Semptember 1, 2022. Data were collected by pretested structured questionnaires. The data were analyzed by SPSS statistical software version 25. Logistic regression, Adjusted Odds Ratio (AOR) with a 95% confidence interval was computed, and variables with a p-value < 0.05 were considered statistically significant. Qualitative data were analyzed using open code version 4.03.

RESULTS

This study revealed that 19.9% (95%Cl: 15.4, 24.2) of study participants use preconception care. Women's autonomy (AOR = 3.65; 95% CI: 1.14, 11.68;P = 0.03), knowledge of PCC (AOR = 3.05; 95% CI: 1.13, 8.22; P = 0.001), getting family/husband support (AOR = 4.06; 95% CI: 1.56, 10.53;P = 0.022), discussions with healthcare providers (AOR = 5.60; 95% CI: 2.26, 13.90;P = 0.002), availability of room for PCC (AOR = 3.77; 95% CI: 1.38, 10.31;P = 0.009), getting all laboratory services (AOR = 4.19; 95% CI: 1.61, 10.94; P = 0.002), and history of medical problems (AOR = 2.94; 95% CI: 11.01, 8.62;P = 0.036) were significantly associated with PCC use.

CONCLUSION

The level of PCC use in the current study area is low. Women's autonomy, knowledge of PCC, obtaining support from family or husband, engaging in discussions with healthcare providers, having access to a PCC room, access to all laboratory services, and having a history of medical problems are significantly associated with PCC use. Our findings suggest integrating PCC into routine HIV care, boosting women's autonomy, and integrating family support with healthcare providers.

A Nurse-Led Initiative to Improve Implementation of HIV Preconception Care Services

ABSTRACT

United States guidelines recommend preconception care (PCC) as an integral part of primary care to improve maternal and fetal/newborn outcomes and promote planned pregnancies. Persons living with HIV have additional, specialized needs for PCC. However, PCC is not reliably integrated in HIV care, and few studies have examined strategies to improve the provision of PCC services. We describe a successful, nurse-led initiative that incorporated collaborative strategic planning in conjunction with staff education and continuous quality improvement to strengthen implementation of PCC in a small urban HIV care clinic. Key features of this project included consensus building, training, and action planning with clinic staff; addressing clinic-specific barriers; and providing ongoing support/technical assistance. Continuous quality improvement reviews at 12, 18, and 36 months demonstrated improved and sustained implementation of PCC services for women and men. Our experiences serve as a model for HIV primary care clinics working to advance implementation of PCC services.

Mobile Phone Based Strategies for Preconception Education in Rural Africa

BACKGROUND

Prepregnancy health care is vital to alleviate and prevent maternal and neonatal disability and death.

OBJECTIVE

The purpose of the study was to measure the levels of knowledge and attitude on preconception care and their determinants among women who delivered at government hospitals in a rural setting in southern Ethiopia.

METHOD

A facility-based cross sectional study was done from January 01 to February 30, 2017 on a sample of 370 women who delivered at government hospitals in Wolayita zone. The mothers were selected using systematic random sampling technique. The data were collected using structured and pretested interviewer administered questionnaires at the postnatal ward of each hospital. Data were analyzed using bivariate and multivariable techniques.

RESULTS

The result showed that 53% (95% confidence interval [CI]: 47.8%, 58.1%) of mothers who delivered at public hospitals had adequate level of knowledge on preconception care, whereas 54.3% (95% CI: 49.2%, 59.5%) possessed positive attitude to preconception care. Mothers who have radio, planned pregnancy and have participated in community meetings related to preconception care had a meaningfully higher odds of good level of knowledge to preconception care. Ordinal regression showed that women who own mobile phone had at least three times significantly higher odds of positive attitude to preconception care, whereas women who have participated community meetings had lower odds of positive attitude on preconception care.

CONCLUSION

The results revealed that the levels of mothers' knowledge and positive attitude on preconception care are low relative to other studies. Using transistor radio and mobile phone have significant effect in improving the knowledge and attitude of reproductive age women on preconception care. Hence, providing community health education based on radio and/or mobile phone messaging could be useful in positively influencing the knowledge and attitude of women on preconception care.