Factors contributing to the low turn up of HIV exposed children for follow up care between 12 to 18 months in Chongwe, Chipata, Livingstone and Ndola districts

Abstract

The impact of loss to follow up of HIV exposed children continues to be a challenge that needs to be addressed especially in communities where people think that HIV testing of HIV exposed children can only be done at 6 weeks. There is an increasing impact of loss to follow up despite the efforts by Ministry of Health and collaborating partners to mitigate the loss to follow up of HIV exposed children. This was observed in HMIS report from 2009 to 2011 where out of 18,037 exposed children who were testing at 6 weeks only 4,519 returned for testing at 18 months representing a 25% drop out in 2009. Similarly 2010, out of 22,494 exposed children who tested at 6 weeks, 7,589 returned for testing at 18 months representing a 33.7% drop out. The dropout rate continued to increase in 2011, which was 34.5% where out of 13,655 who were tested at 6 weeks only 4,724 returned for HIV testing at 18 months.This study aimed at determining the factors contributing to low turn up of HIV exposed children at 12 and 18 months in four selected districts namely; Chipata, Chongwe, Livingstone and Ndola.A descriptive study design was used. Data were collected using a structured interview schedule from 200 randomly selected respondents in the four selected districts. Data were entered and analysed using Microsoft office excel and SPSS spreadsheets.The study revealed that the majority 184 (92%) of the respondents had high knowledge on follow up care services, majority 149 (75%) had a positive attitude towards utilisation of follow up care services and 151 (76%) had good utilisation of follow up care services at 6 weeks.Despite the majority having high knowledge and positive attitude towards follow up care, the majority 163 (81%) did not take their children for HIV testing at 12/18 months. The following were the reasons for not taking their children; 50 (31%) of the respondents said that they did not take their children for HIV testing because they were busy, 46 (28%) was due to stigma, 30 (18%) said their children were fine, 23 (14%) was due to being guilty, 8 (5%) was due to long distance while 6 (4%) was due to long waiting time.The study revealed that majority of the respondents had knowledge and positive attitude towards follow up care. Despite the respondents having positive attitude towards follow up care, the level of utilization of follow up care services particularly HIV testing at 12 and 18 months was low since 81% did not take their children for follow up care. The findings show that respondents had various reasons for not taking their children for HIV testing. The main reason for not taking their children for HIV testing was that they have a busy schedule as mothers/caretakers spend most of their time trying to make ends meet.The study targeted the mothers/caretakers as respondents. There is therefore need to conduct an in-depth study from the service providers' point of view which may reveal other factors contributing to low turn up of HIV exposed children at 12 and 18 months.