A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa

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dc.contributor.advisorStinson, Kathrynen_ZA
dc.contributor.authorKirya, Violaen_ZA
dc.date.accessioned2016-08-11T10:21:21Z
dc.date.available2016-08-11T10:21:21Z
dc.date.issued2016en_ZA
dc.description.abstractObjectives: The aim of this study was to explore the experiences and perceptions of counsellors and patients towards a new counselling model for HIV-positive pregnant women on Option B+ at an antenatal clinic in South Africa and to describe the cohort of HIV-positive pregnant women who experienced the new counselling model. Methods: A mixed methods study design was employed. The quantitative data collection involved using retrospective cohort quantitative data of women that were initiated on Option B+ during the period of 1 October 2013 to 30 June 2014. The variables of interest included: age, gravidity, antiretroviral therapy initiation date, viral load result and number of counselling sessions completed. These were obtained from patient folders and from the Department of Health patient electronic health record. The data was analysed using STATA 12. The qualitative data involved semi-structured interviews of patients and counsellors who had experienced the counselling model. Results: The number of women who completed a total of 1, 2, 3 or 4 counselling sessions was 25%, 26%, 48% and 1% respectively. The percentage of women that were retained in care for more than 8 weeks postnatal was 53%. Of the women with VL results, 92% were virally suppressed. The Fisher's exact test showed a P-value of 0.05 at a level of significance of P ≤ 0.05. Therefore there is sufficient evidence to show that there is a positive association between the number of counselling sessions completed and number of postnatal days in care. The study also found that from the counselling, the women gained social support, knowledge about: antiretroviral therapy, HIV, drug side effects and infant feeding. Conclusion: The poor uptake of the counselling intervention includes poor communication, service delivery challenges and social factors. The main motivation for initiating ART and maintaining adherence to treatment was to protect the baby and as a result, some women maintained adherence despite not completing the counselling. Women valued the education that they received during the counselling sessions and this influenced their adherence. Psychosocial support from the counsellors and peers was found to be vital to the women and this highlighted the need to incorporate a support group for the pregnant women, as part of the intervention. The findings also suggest that when offering counselling interventions to pregnant women, a balance between psychosocial support, practical support and patient education needs to be struck. Finally, education of the community on the importance of counselling is important in order to improve the uptake of the counselling because interventions aimed at mothers do not always take into account the influence of the social environment on the uptake of the intervention.en_ZA
dc.identifier.apacitationKirya, V. (2016). <i>A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/21194en_ZA
dc.identifier.chicagocitationKirya, Viola. <i>"A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2016. http://hdl.handle.net/11427/21194en_ZA
dc.identifier.citationKirya, V. 2016. A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kirya, Viola AB - Objectives: The aim of this study was to explore the experiences and perceptions of counsellors and patients towards a new counselling model for HIV-positive pregnant women on Option B+ at an antenatal clinic in South Africa and to describe the cohort of HIV-positive pregnant women who experienced the new counselling model. Methods: A mixed methods study design was employed. The quantitative data collection involved using retrospective cohort quantitative data of women that were initiated on Option B+ during the period of 1 October 2013 to 30 June 2014. The variables of interest included: age, gravidity, antiretroviral therapy initiation date, viral load result and number of counselling sessions completed. These were obtained from patient folders and from the Department of Health patient electronic health record. The data was analysed using STATA 12. The qualitative data involved semi-structured interviews of patients and counsellors who had experienced the counselling model. Results: The number of women who completed a total of 1, 2, 3 or 4 counselling sessions was 25%, 26%, 48% and 1% respectively. The percentage of women that were retained in care for more than 8 weeks postnatal was 53%. Of the women with VL results, 92% were virally suppressed. The Fisher's exact test showed a P-value of 0.05 at a level of significance of P ≤ 0.05. Therefore there is sufficient evidence to show that there is a positive association between the number of counselling sessions completed and number of postnatal days in care. The study also found that from the counselling, the women gained social support, knowledge about: antiretroviral therapy, HIV, drug side effects and infant feeding. Conclusion: The poor uptake of the counselling intervention includes poor communication, service delivery challenges and social factors. The main motivation for initiating ART and maintaining adherence to treatment was to protect the baby and as a result, some women maintained adherence despite not completing the counselling. Women valued the education that they received during the counselling sessions and this influenced their adherence. Psychosocial support from the counsellors and peers was found to be vital to the women and this highlighted the need to incorporate a support group for the pregnant women, as part of the intervention. The findings also suggest that when offering counselling interventions to pregnant women, a balance between psychosocial support, practical support and patient education needs to be struck. Finally, education of the community on the importance of counselling is important in order to improve the uptake of the counselling because interventions aimed at mothers do not always take into account the influence of the social environment on the uptake of the intervention. DA - 2016 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa TI - A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa UR - http://hdl.handle.net/11427/21194 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21194
dc.identifier.vancouvercitationKirya V. A mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2016 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/21194en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPublic Healthen_ZA
dc.subject.otheradherenceen_ZA
dc.subject.othercounsellingen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherPrevention of mother-to-child transmissionen_ZA
dc.titleA mixed methods study to explore the outcomes, experiences and perceptions of women who attended a new counselling model for HIV-positive pregnant women accessing antenatal services in Khayelitsha, Cape Town, South Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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