Predictors of HIV Positive Women’s Use of Hospital Delivery Services in Taraba State A Mixed Method Approach

Abstract

Background: Access to hospital-based services is important for optimal prevention of mother-to-child transmission of HIV outcomes. Women who deliver outside health facilities are less likely to receive ARVs and quality obstetric care, and may suffer complications leading to vertical HIV transmission and maternal and infant mortality. These services may be available but certain factors interfere with their access and utilization by HIV positive pregnant women. This study assessed factors that predict the utilization of hospital delivery services among HIV positive pregnant women in Taraba State.

Methods: The study adopted a concurrent mixed method research design employing an institutional based cross sectional and phenomenology design. The population for the study consisted of 3,315 HIV positive women attending post natal and infant welfare Clinic. Multi-stage sampling technique was used to select hospitals for the study. Convenience random sampling technique was used to select 605 HIV positive women who were present during post natal clinic days and gave their consent. The key informant participants for the study were selected using purposive sampling technique. The POHPWUOHDS questionnaire and key informant interview guide were used for data collection. Frequencies, percentages, chi-square and logistic regression analyses were used to analyze the quantitative data while the qualitative data were thematically analyzed using Nvivo software.

Results: The results showed hospital delivery rate of 56.1%, counseling services of 57.8%, utilization of caesarean section 35.3%, utilization of single dose nevirapine services  60.1% and utilization of co-trimoxazole syrup 64.0%. Chi-square test of association revealed that age, level of education and marital status were associated with hospital delivery. The results for logistic regression for hospital delivery show that women (15-29 years) (OR=1.66 ; CI= 1.089- 2.53 p= .02) were more likely to deliver in the hospital.

Conclusion: The study concluded that utilization of hospital delivery is high among HIV positive women. However, with proper public enlightenments the rate of utilization of hospital delivery especially among the older women will increase since every woman wants to have healthy children. Therefore the government should endeavour to increase public awareness especially among the older clients.