A Dissertation Submitted in Partial Fulfillment of Requirements for the Degree
of Master of Science in Health Monitoring and Evaluation of Mzumbe University
The world anticipated to reach 90% antiretroviral therapy (ART) coverage by 2015
(UNAIDS, 2013). Despite free provision of ART to pregnant women living with HIV,
still ART uptake remains low. Therefore this study aimed at evaluating factors for low
uptake of ART among pregnant women living with HIV in Mbeya City Council.
The cross section descriptive study with convenient selection of 12 health providers
and 44 pregnant women on ART, and purposive selection of 4 key informants were
conducted. Review of data; in-depth interviews (IDIs) with clients and key
informants, exit interviews with clients and observation for health providers were
conducted. Audio tape recording from IDIs was transcribed into Swahili then back to
English. Data coded and analysed using Atlas. ti 7 to determine factors for low uptake
of ART. The quantitative data were analysed using excel spread sheet to determine the
rate of ART uptake.
The evaluation revealed that the rates of ART uptake are still not increasing as
expected by the programme to reach 90% by the end of 2015. The significant
decreasing rates seen in 2 health facilities which started with high percentage then
dropped without improvement, while 6 facilities had unstable ART uptake rates as
dropped the uptake rate then came up again, Likewise, individual factors like faith
believes in God and treatment related side effects, social factors like lack of partner
support and traditional medicine, and health service factors like long waiting time for
service and discrepancy in information given to clients on ART were factors
contributed to low uptake of ART
This study indicates that various factors at individual, social and health service levels
were more likely to cause failure of clients to continue with ART. However reasons
for discrepancy information during counseling by providers remain a question which
needs further researching. Therefore, the study recommends that regular supervision
should cover checking of data, in plant walkthrough and client exit interview to
capture relevant information given to clients for raising ART uptake rates