Improving access to PMTCT services via a novel implementation model: organizational support, health education, and HIV testing at the community level of West Java, Indonesia

Research output: Contribution to journalArticle

Abstract

In Indonesia, access to services for the prevention of mother-to-child transmission (PMTCT) is quite low. The objective of this study was to design and implement a model to improve access to PMTCT services. This study was a quasi-experimental design involving 770 pregnant women in 2 districts (intervention and control district; n = 385 each). The implementation model had four stages: exploration, installation, initial implementation, and full implementation. The key activities included the provision of health education, an offering HIV testing, and the implementation of HIV tests for pregnant women in the community. The success of the model was assessed using three indicators: 1) the increase in the proportion of health facilities offering PMTCT services, 2) increase in the proportion of pregnant women who were offered HIV testing, and 3) increase in the proportion of pregnant women underwent HIV testing. The effectiveness of the model was assessed using multiple logistic regression analysis. In the intervention district, the number of facilities that offered PMTCT services increased from 6% to 34%, and the number of pregnant women who underwent HIV tests increased from 4.7% to 85.5%. Pregnant women in the intervention district showed greater access to PMTCT after controlling by the education of pregnant women, the role of decision making in the family, education and knowledge of the husband (odds ratio = 63.6; 95% confidence interval: 38.9–103.8; p = 0.000). The implementation model effectively improved access to PMTCT services. A multi-phased approach implemented in this study was able to overcome the barriers to access PMTCT services.

Original languageEnglish
JournalInternational Journal of Health Promotion and Education
DOIs
Publication statusAccepted/In press - 1 Jan 2020

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Organizational Models
Indonesia
Health Education
Pregnant Women
Mothers
HIV
Education
Health Facilities
Spouses
Decision Making
Research Design
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals

Keywords

  • health education
  • HIV testing
  • Implementation model
  • PMTCT
  • West Java

Cite this

@article{b1d85c4e7e714535b63ff373a36a609f,
title = "Improving access to PMTCT services via a novel implementation model: organizational support, health education, and HIV testing at the community level of West Java, Indonesia",
abstract = "In Indonesia, access to services for the prevention of mother-to-child transmission (PMTCT) is quite low. The objective of this study was to design and implement a model to improve access to PMTCT services. This study was a quasi-experimental design involving 770 pregnant women in 2 districts (intervention and control district; n = 385 each). The implementation model had four stages: exploration, installation, initial implementation, and full implementation. The key activities included the provision of health education, an offering HIV testing, and the implementation of HIV tests for pregnant women in the community. The success of the model was assessed using three indicators: 1) the increase in the proportion of health facilities offering PMTCT services, 2) increase in the proportion of pregnant women who were offered HIV testing, and 3) increase in the proportion of pregnant women underwent HIV testing. The effectiveness of the model was assessed using multiple logistic regression analysis. In the intervention district, the number of facilities that offered PMTCT services increased from 6{\%} to 34{\%}, and the number of pregnant women who underwent HIV tests increased from 4.7{\%} to 85.5{\%}. Pregnant women in the intervention district showed greater access to PMTCT after controlling by the education of pregnant women, the role of decision making in the family, education and knowledge of the husband (odds ratio = 63.6; 95{\%} confidence interval: 38.9–103.8; p = 0.000). The implementation model effectively improved access to PMTCT services. A multi-phased approach implemented in this study was able to overcome the barriers to access PMTCT services.",
keywords = "health education, HIV testing, Implementation model, PMTCT, West Java",
author = "Dewi Purnamawati and Ratna Djuwita and Kemal Siregar and Sudijanto Kamso and Budi Utomo and Hadi Pratomo and Toha Muhaimin",
year = "2020",
month = "1",
day = "1",
doi = "10.1080/14635240.2019.1695525",
language = "English",
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AU - Purnamawati, Dewi

AU - Djuwita, Ratna

AU - Siregar, Kemal

AU - Kamso, Sudijanto

AU - Utomo, Budi

AU - Pratomo, Hadi

AU - Muhaimin, Toha

PY - 2020/1/1

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N2 - In Indonesia, access to services for the prevention of mother-to-child transmission (PMTCT) is quite low. The objective of this study was to design and implement a model to improve access to PMTCT services. This study was a quasi-experimental design involving 770 pregnant women in 2 districts (intervention and control district; n = 385 each). The implementation model had four stages: exploration, installation, initial implementation, and full implementation. The key activities included the provision of health education, an offering HIV testing, and the implementation of HIV tests for pregnant women in the community. The success of the model was assessed using three indicators: 1) the increase in the proportion of health facilities offering PMTCT services, 2) increase in the proportion of pregnant women who were offered HIV testing, and 3) increase in the proportion of pregnant women underwent HIV testing. The effectiveness of the model was assessed using multiple logistic regression analysis. In the intervention district, the number of facilities that offered PMTCT services increased from 6% to 34%, and the number of pregnant women who underwent HIV tests increased from 4.7% to 85.5%. Pregnant women in the intervention district showed greater access to PMTCT after controlling by the education of pregnant women, the role of decision making in the family, education and knowledge of the husband (odds ratio = 63.6; 95% confidence interval: 38.9–103.8; p = 0.000). The implementation model effectively improved access to PMTCT services. A multi-phased approach implemented in this study was able to overcome the barriers to access PMTCT services.

AB - In Indonesia, access to services for the prevention of mother-to-child transmission (PMTCT) is quite low. The objective of this study was to design and implement a model to improve access to PMTCT services. This study was a quasi-experimental design involving 770 pregnant women in 2 districts (intervention and control district; n = 385 each). The implementation model had four stages: exploration, installation, initial implementation, and full implementation. The key activities included the provision of health education, an offering HIV testing, and the implementation of HIV tests for pregnant women in the community. The success of the model was assessed using three indicators: 1) the increase in the proportion of health facilities offering PMTCT services, 2) increase in the proportion of pregnant women who were offered HIV testing, and 3) increase in the proportion of pregnant women underwent HIV testing. The effectiveness of the model was assessed using multiple logistic regression analysis. In the intervention district, the number of facilities that offered PMTCT services increased from 6% to 34%, and the number of pregnant women who underwent HIV tests increased from 4.7% to 85.5%. Pregnant women in the intervention district showed greater access to PMTCT after controlling by the education of pregnant women, the role of decision making in the family, education and knowledge of the husband (odds ratio = 63.6; 95% confidence interval: 38.9–103.8; p = 0.000). The implementation model effectively improved access to PMTCT services. A multi-phased approach implemented in this study was able to overcome the barriers to access PMTCT services.

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KW - HIV testing

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