COME ONE, COME ALL: INCREASING MALE INVOLVEMENT
MBEZI DISPENSARY RCH/PMTCT SERVICES
KINONDONI DISTRCT- SEPT 2013


INTRODUCTION
Mbezi dispensary as a public health facility was established in 1974. The facility serves the population that resides in Kinondoni district. Different services are provided in the facility including RCH services which were introduced in 1979 after the construction of a building for reproductive and child health clinic. During that time, in a month, the number of male attending ANC was 0-1% compared to new pregnant mothers.

Number of males attending RCH clinic with their female partners started to increase gradually in 2004 to 2010 to about 5-10% in a month. This was due to sensitization and health education which was provided to pregnant mothers on the importance of attending clinic with their spouses.

PMTCT services started in 2010 by screening pregnant mothers for HIV voluntarily.

The major challenges observed were:

  • Stigma and discrimination of pregnant mothers identified to be HIV positive by their spouses. Divorce incidents were reported.
  • Disclosure of HIV status to partners was another problem which affected ARV drug adherence.
  • It was difficult for a pregnant mother to choose proper method of infant feeding to prevent HIV transmission from mother to child.


Due to the above mentioned reasons, health care providers decided to set strategies to overcome the observed challenges

STRATEGIES

  1. Every health care provider was involved in sensitization and emphasizing the importance of every pregnant woman to come with her male partner for HIV testing.
  2. Pregnant mothers who came with their partners were given priority in services provision.
  3. Health education was provided every day on the importance of male involvement. The aim being to disseminate information on their partners health progress and knowledge on health issues related to pregnancy.
  4. Sensitization meeting with ward and street  authorities including the chairmen and ten cell leaders was conducted. The discussion was on the advantage of male involvement in RCH/PMTCT services for better health of mother and child.
  5. Facility board members were encouraged to sensitize people at the community in their regular meetings.
  6. Posters were displayed in different areas at the health facilities advocating male involvement in RCH/PMTCT services. Some posters were displayed at the offices of the ward and street authories. MDH provided posters while facility supplemented locally made ones.
  7. Experienced male who benefited the services ware involved in experience sharing on the importance of attending ANC during health education sessions.
  8. One of the methods which was used  in provision of Health education was participatory discussions.
  9. Good communication skills were demonstrated between HCP and clients to provide conduce environment for  male partner involvements.
  10. Clients were given opportunity to give their comments/suggestions on how to improve the services.
  11. Male satisfaction on the services provided at RCH promoted number of male attending RCH clinic with their female partners. This is because, they have now become ambassadors of male involvement  and hence assist in advocating to the community  the good service which is provided at Mbezi RCH/PMTCT clinic
  12. Ensuring availability of HIV test kits with support from MDH by gap filling when Municipal did run short of rapid  HIV Test was a priority
  13. Team work and good leadership at different levels at the facility assisted a lot in solving minor gaps that were found along the way.

Data on Couple attendance 2010 to 2013 and trend of consecutive years:


Fig 1: Number of couples attending RCH/PMTCT clinic per year at Mbezi dispensary

mbezi

Table 1: Data on Males vs Females screened for HIV July – Sept 2013

Number of male tested for HIV against new pregnant women  in the last Quarter of  July -Sept 2013
  Number of female tested for HIV Number of male teste for HIV %Male tested for HIV
July 123 102 83%
Aug 168 152 90.5%
Sept 164 154 94%

Fig 2: Number of Females Vs Number of males tested for HIV per month at Mbezi

Dispensary from July to September 2013

mbezi2

CHALLENGES

  • Inadequate space compared to number of clients. That one room is used for  counseling and testing.
  • Shortage of staff resulted into long queues waiting time.

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