| dc.description.abstract | Introduction: The Option B+ strategy for EMTCT recommends maternal lifelong triple ART
once HIV diagnosis is made. It has advantages and was rolled out to health facilities as MoH
policy. Whereas Uganda has invested in this strategy, studies show that retention on this program
is poor in Sub-Saharan Africa (SSA) and is influenced by several factors. There’s a paucity of
data on the determinants of retention among mothers on the Option B+ program in Uganda’s
urban settings. This study determines one-year retention rates and describes the individual, health
system and community factors influencing maternal retention on the Option B+ program within
six urban health centers in Kampala.
Methodology: A retrospective cohort study was conducted through a review of records of 862
HIV positive mothers enrolled into Option B+ EMTCT care in 2015. Structured questionnaireguided interviews with health care workers, community leaders, mothers on EMTCT care
programs, and their care takers were conducted to qualitatively assess for the determinants of
retention in care. Statistical logistic regression models and deductive thematic content analyses
were used to determine and describe the variables associated with maternal retention on Option B+
EMTCT care.
Results: The 12-month maternal retention on Option B+ care was 53.6% across the six health
facilities. Religion, marital status, gestational age and WHO stage at enrolment determined
retention in care. Catholics had almost 3 times the odds of being in care compared to the Born
Again Christian (OR, 95% CI: 2.84, 2.01-4.02), p<0.001) and being a Moslem was protective of
dropping out of care OR, 95% CI:1.4(1.01-2.06, p=0.045). The never married and those who had
separated/divorced/widowed were more likely to drop out of care compared to married women
(OR, 95%CI: 0.68, 0.47-0.98, p=0.039 and 0.56, 0.33-0.97, p=0.037) respectively. Women who
came in their 2nd trimester were more likely to stay in care compared to those who came in their
1
st trimester (OR, 95%CI, 1.73, 1.06-2.80, P=0.027). Mothers enrolled at WHO stage 2&3 were
more likely to stay in care compared to those who were at stage 1 (OR, 95%CI, 1.98, 1.01-3.87,
P=0.046).
Conclusion: Within the six KCCA public health facilities, twelve-month maternal retention on
Option B+ PMTCT care programs is poor. It is significantly determined by religion, marital status,
gestational age and WHO stage at enrolment.
Recommendation: In order to ensure continuous engagement of mothers in EMTCT care, HIV
care programs have to support health system and community interventions that address retention
barriers at various levels | en_US |
