THE EFFECT OF HIV/AIDS TRAINING ON THE KNOWLEDGE AND PRACTICE OF TRADITIONAL BIRTH ATTENDANTS AT THE LOCAL GOVERNMENT LEVEL IN LAGOS STATE
Introduction: In sub-Saharan Africa, 59% of adults living with HIV are women. As more women contract the virus, the number of children infected from their mothers has been growing. Worldwide, more than one million women infected with HIV are estimated to deliver their babies without the help of skilled birth attendants. This study was carried out to determine the effects of HIV/AIDS training on the knowledge and practice of Prevention of Mother-To-Child Transmission of HIV (PMTCT) amongst traditional birth attendants at the local government level in Lagos State.
Materials and methods: This study was a non-randomised, controlled intervention study. Multistage sampling method was used to select the intervention and control communities and all registered traditional birth attendants were recruited for the study. Following the pre-intervention interviewer-administered questionnaire survey, an HIV/AIDS training program was conducted for the intervention group employing question and answer sessions, group discussions, role-plays, didactic lectures, trainer demonstration, use of pictures and sharing experiences. Post-intervention questionnaire administration was done after six months.
Results: Pre-intervention, the study found that all the respondents were aware of HIV but their awareness of Prevention of Mother-To-Child Transmission of HIV (PMTCT) specifically was not as high. Only 10.4% and 4.9% of respondents in the intervention and control groups respectively had good level of knowledge about HIV and PMTCT. The practice of HIV counseling of all patients among intervention (29.9%) and control (36.6%) groups was low, similarly for the referral of all patients for HIV testing (35.5% and 53.7% respectively). Higher levels of knowledge
positively influenced these practices significantly (p < 0.05). About 10.4% and 4.9% of the intervention and control groups did not keep any record of their work.
The HIV/AIDS training intervention program significantly increased the overall level of knowledge in the intervention group compared to the control group. However, the increases in the proportions of respondents in the intervention group that knew HIV could not be cured and mentioned sex as a mode of HIV transmission were not statistically significant and 20.3% of them still had misconceived notions of modes of transmission of HIV. There was a significant improvement in the practice of HIV counseling of patients in the intervention group compared to the control group; significant improvements in the practice of referral of patients for HIV testing was evident in both groups. There was however no significant improvement in the practice of record keeping and the records kept on tally sheets by the intervention group showed some deficiencies.
Conclusion: HIV/AIDS training succeeded in improving the level of knowledge and practice of PMTCT of TBAs although some areas of deficiency still persist.
Recommendations: Periodic re-training and adequate supervision of traditional birth attendants at the local government level is necessary to fill in the gaps in their knowledge and practice.