Articles

The roles of private practice midwives in Prevention of Mother-To-Child Transmission Program (PMTCT) in Bali Province, Indonesia

I Ketut Dwipayana , Pande Putu Januraga, Ni Made Dian Kurniasari

I Ketut Dwipayana
Petang 1 Public Health Center. Email: drdwipayana@gmail.com

Pande Putu Januraga
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University

Ni Made Dian Kurniasari
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University
Online First: December 31, 2020 | Cite this Article
Dwipayana, I., Januraga, P., Kurniasari, N. 2020. The roles of private practice midwives in Prevention of Mother-To-Child Transmission Program (PMTCT) in Bali Province, Indonesia. Public Health and Preventive Medicine Archive 8(2): 99-105. DOI:10.15562/phpma.v8i2.273


Background and purpose: Mother-to-child transmission of HIV has been one of the problems in HIV prevention. In Indonesia, private practice midwives (PPM) play an important role in maternal and child health services. The roles of PPM in HIV vertical transmission prevention through PMTCT have not yet clearly understood. This research aims to analyse the roles of PPM in Bali Province in the PMTCT program as well as the PPM’s characteristics, knowledge, and attitudes about the program.

Methods: This study was a descriptive cross-sectional survey, conducted from March to May 2020. The study population was PPM in Bali Province. The samples obtained were 404 out of a total of 1,736 PPM (23% response rate). The variables studied included socio-demographic characteristics, services and resources characteristics, knowledge, attitudes, and the role of PPM in four PMTCT prongs. Data was collected via self-filled online questionnaires distributed through Indonesian Midwives Associations branches in every district/city in Bali Province. Data were analysed descriptively and differences in roles in PMTCT were analysed using the chi-square test.

Results: Of the 404 PPM, 66.1% served childbirth (deliveries), 25.4% had served HIV-positive women, and 18.3% had served HIV-positive pregnant women. As many as 95.5% of PPM played a good role in prong 1, and 99.0% of PPM, who had served HIV positive patients, played a good role in prong 2, 3 and 4. Statistically significant determinants for good implementation of prong 1 of PMTCT by the PPM were indicated by ownership or access to PMTCT information media (p=0.026), experience of serving HIV positive women (p<0.00), and having served higher number of PMTCT patients (p=0.019).

Conclusion: The PPM in Bali Province has played a good role in PMTCT, with a significant difference for good PMTCT implementation in prong 1 determined by the availability of information media, a history of serving HIV-positive women, and the number of PMTCT patients who have been served.

References

World Health Organization. HIV/AIDS Key facts [Internet]. WHO. 2019 [cited 2019 Jul 17]. p. 1–9. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids

UNAIDS. Global HIV & AIDS statistics - 2019 fact sheet [Internet]. UNAIDS. 2019 [cited 2019 Jul 20]. p. 1–9. Available from: https://www.unaids.org/sites/default/files/media_asset/2019-UNAIDS-data_en.pdf

John-Stewart G, Peeling RW, Levin C, Garcia PJ, Mabey D, Kinuthia J. Prevention of Mother-to-Child Transmission of HIV and Syphilis. Disease Control Priorities, Third Edition (Volume 6): Major Infectious Diseases. 2017. 113–136 p.

Ngwende S, Gombe NT, Midzi S, Tshimanga M, Shambira G. Factors associated with HIV infection among children born to mothers on the prevention of mother to child transmission programme at Chitungwiza Hospital , Zimbabwe. BMC Public Health. 2013; 13:1181.

World Health Organization. HIV/AIDS mother-to-child transmission of HIV. [Internet]. WHO. 2020 [cited 2020 Jun 11] 2020; 2014–5. Available from: https://www.who.int/hiv/topics/mtct/about/en/

AVERT. Prevention of mother-to-child transmission (PMTCT) of HIV [Internet]. 2018 [cited 2019 Aug 20]. Available from: https://www.avert. org/professionals/hiv-programming/prevention/prevention-mother-child

The Ministry of Health of the Republic of Indonesia. General situation of HIV/AIDS and HIV test. [Internet]. The Ministry of Health of the Republic of Indonesia. 2018 [cited 2019 Jun 30]. https://pusdatin.kemkes.go.id/article/ view/19042200004/situasi-umum-hiv-aids-dan-tes-hiv.html

Bali Provincial Health Office. Profil Kesehatan Provinsi Bali Tahun 2017. [The 2017 Bali Province Health Profile] [Internet]. 2017. [cited 2019 Sep 10]. Available from: http://www.diskes.baliprov.go.id/files/subdomain/ diskes/ProfilKesehatanProvinsi Bali/Tahun 2015/Bali_Profil_2015.pdf

The Ministry of Health of the Republic of Indonesia. Pedoman Manajemen PPIA [The Guidelines of Mother-To-Child-Transmission Management]. The Ministry of Health of the Republic of Indonesia. Jakarta; 2015. 43 p.

Wulandari LPL, Lubis DSM, Widarini P, Widyanthini DN, Wirawan IMA, Wirawan DN. HIV testing uptake among pregnant women who attending private midwife clinics: challenges of scaling up universal HIV testing at the private sectors in Indonesia. Int J Health Plann Manage. 2019;34(4):1399-1407.

UNICEF. Kesehatan Ibu & Anak [Mother and Child Health]. UNICEF Indonesia [Internet]. 2012; (Gambar 2):1–2. Available from: http://www.unicef.org/indonesia/id/A5_-_B_Ringkasan_Kajian_Kesehatan _REV.pdf

Widiastuti NMR, Adnyani NWS. The implementation of prevention of mother-to-children HIV transmission program by private midwife practice at Denpasar City. Int J Res Med Sci. 2018;7(1):121.

Rowan BH, Robinson J, Granato A, Bla CK, Kouyaté S, Djety GV, et al. Workforce patterns in the prevention of mother to child transmission of HIV in Côte d’Ivoire: A qualitative model. Hum Resour Health. 2018;16(1):1–9.

The Elizabeth Glaser Pediatric Aids Foundation (EGPAF). Mother-To-Child Transmission of HIV Services in Lesotho. 2013.

Meilani N, Setiyawati N, Barasa SO. Midwife’s Role in the Mother-to-Child Transmission Prevention Program in Primary Health Care in Yogyakarta. Natl Public Heal J. 2019;14(2):88–94.

Ogbonna K, Govender I, Tumbo J. Knowledge and practice of the prevention of mother-to-child transmission of HIV guidelines amongst doctors and nurses at Odi Hospital, Tshwane District. South African Fam Pract. 2016;58(5).

Erliana N, Suryoputro A, Mustofa SB. Gambaran Pelaksanaan Prevention Mother to Child Transmission di RSUD Kelas B Dr. R. Sosodoro Djatikoesoemo Kabupaten Bojonegoro [The description on Prevention of Mother to Child Transmission Program at Class B Dr. R. Sosodoro Djatikoesoemo District Hospital, Bojonegoro]. J Promosi Kesehat Indones. 2018;11(2):1.

Yuliansyah. Meningkatkan Response Rate pada Penelitian Survey-Suatu Study Literature [Increasing response rate in a survey study - a literature study]. Change Publisher. Edisi I. Jakarta. 2016.


No Supplementary Material available for this article.
Article Views      : 33
PDF Downloads : 16