Barriers To Early Infant Diagnosis And Service Delivery In Two High Hiv Districts In Ghana

Abstract

Objective: Ghana has made significant progress in its efforts to control Human Immunodeficiency virus (HIV) infections, however 31% of HIV exposed infants received early infant diagnosis (EID) services. This paper examines the factors influencing EID service delivery in two high HIV burden districts in Ghana.

Methodology: This study was conducted in two districts in the Eastern region of Ghana, Lower Manya Krobo (LMK) District (high HIV burden with low EID coverage) and New Juabeng Municipality, NJM (high HIV burden with relatively higher coverage for EID). This analysis describes the first phase (exploratory study) of a three-phased implementation research spanning over 24 months. A total of 420 women with children < 2 years in each study area were involved. Key informant interviews and focus group discussions were conducted among mothers and health workers.

Data (quantitative and qualitative) were analysed with appropriate statistical measures.

Results: Relatively more women from LMKD knew about the risks for mother-to-child transmission of HIV (83.6% vs. 79.8%) and more women in LMKD had children <2 years tested for HIV. In contrast to findings from the survey, knowledge on EID during Focus Group Discussions was better in NJM than LMKD. Major demand and supply -side barriers and challenges to EID were identified. 

Conclusion: Health system (supply side) and community based (demand side) barriers mitigated against the EID coverage in the two districts. More community sensitisation, improved innovative means of transporting samples and effective tracking of mothers with HIV exposed infants and linking them up to care is recommended.