Data from 33 national health surveys reveals a gap in knowledge, particularly among adolescent girls, uneducated women and those with low incomesData from 33 national health surveys reveals a gap in knowledge, particularly among adolescent girls, uneducated women and those with low incomes
An analysis of national health surveys from 33 countries in sub-Saharan Africa suggests just 56% of women fully understand how to prevent mother-to-child-transmission of HIV (PMTCT).
Until now, most PMTCT research has involved women at health facilities, mainly those receiving antenatal care. But because many women in sub-Saharan Africa live in rural areas that are often far away from health clinics, these findings may not give the whole picture.
The study’s data is from Demographic and Health Surveys conducted between 2008 and 2019. It relates to 350,888 women of reproductive-age.
The median age of women in the study was 28 and the most common level of education was secondary education (36%). Around 60% lived in rural areas.
Between 79% and 90% of women knew HIV can be transmitted during pregnancy, delivery or breastfeeding and that medication can prevent transmission.
But only 56% fully understood how to prevent mother-to-child transmission. There was a wide variation between countries. In Zambia, three-quarters (76%) of women had adequate PMTCT knowledge, compared to 14% in Comoros.
Women from certain groups were more likely to understand PMTCT than others.
Adolescent girls (ages 15-19) were less likely to have adequate PMTCT knowledge than women aged 20 and above.
The majority (64%) of women did not think the distance they lived from a health facility was a big problem. But those that did see it as a problem were less likely to have adequate knowledge of PMTCT than others.
Women who had access to a television, a newspaper or the radio (74%) were more likely to have adequate PMTCT knowledge than women who did not. This was also the case for women with at least primary-level education and from households with adequate household income. The finding on income may be because women from these households could afford to travel to health facilities and pay for other treatment-related costs.
Having given birth to more than one child was also associated with having adequate PMTCT knowledge. This is because the more children a woman has the more likely she is to come into contact with maternal health services, which includes HIV testing and counselling.
Because this study used DHS data some factors that may affect PMTCT knowledge, such as the quality of health services, were not assessed.
But despite this limitation, the findings suggest that adolescent girls, first-time mothers, uneducated women and those with low incomes would benefit from schemes that provide information on PMTCT in ways they can access and make sense to them.