RESUMEN
BACKGROUND: India has the third largest human immunodeficiency virus (HIV) epidemic in the world, with 15,000 newborns infected every year. Prevention of mother-to-child transmission (PMTCT) services can eliminate new HIV infections. Nondisclosure of positive HIV status and nonoptimal uptake of PMTCT are related. Therefore, understanding different aspects of HIV disclosure are necessary for program managers and careproviders for prevention and support. OBJECTIVE: The present research explores HIV disclosure narratives, the family's perspective, and theoretical framework in the context of PMTCT. METHODS: A qualitative study was conducted among 31 (16 mothers and 15 fathers) utilizers of PMTCT at an urban antiretroviral therapy center. A semi-structured in-depth interview guide based on disclosure process model (DPM) was used to explore HIV disclosure goals and outcomes by both members of parental dyad. The recorded interviews were transcribed verbatim, translated into English, and analyzed with Atlas.ti software. Directed content analysis was used to code data according to "a priori" and emerging themes. Demographic data were analyzed using descriptive statistics. RESULTS: Limited disclosure is a necessity for pregnant women and their male partners for approach coping with HIV diagnosis and pursuing positive support for PMTCT adherence. Interpersonal, society, and community contextual outcomes affect the care uptake and future likelihood of disclosure. CONCLUSIONS: DPM suggestions from the present study can be used to facilitate a goal-directed process that allows parents/PLWHA to selectively disclose their HIV status to family members and acquaintances for obtaining maximum support to eliminate newborn HIV infections while minimizing distress, stigma, and discrimination.
RESUMEN
BACKGROUND: With the wide variation in sexually transmitted infection (STI) services, it is a challenge to devise strategies for ensuring effective service delivery. The objectives of this study were to develop a standard tool for STI services evaluation and use the Delphi method to derive a weighted factor for each parameter of the tool. METHODS: A review of existing guidelines for quality care STI services were conducted, and parameters were selected to form the content of the measurement tool. Delphi technique was used to derive weighted factor for each STI service delivery parameter by using the Likert scale of 0-7. A heterogeneous group of 18 anonymous experts was invited to rate the parameters. All the responses were collected online. Cronbach's alpha level ≥0.8 was selected to define consensus the experts. RESULTS: The STI service evaluation tool (SSET) was created including ten parameters to evaluate the performance of clinic with the help of standard National guidelines. The SSET was standardized by deriving weighted factor for each evaluation parameter. Three rounds of Delphi were required to achieve consistency. Response rates for each Delphi round were 77.78%, 100%, and 78.57%, respectively. Each parameter, such as workforce, materials, consumables, consultation, counseling, coverage, referral, records, information education and communication, and supervision, was assigned weighted factor derived by converting the final score into the total standard score of 100. CONCLUSION: The Delphi method represents a novel approach to develop standardized tools to evaluate the performance of service delivery.
RESUMEN
OBJECTIVE: To develop and validate domains to assess attendee's gain at sexually transmitted infection (STI) clinic and their understanding after utilizing services at STI Clinic. METHODS: Study was done in two phases. In-depth interviews were conducted to explore attendee's perception. Domains generated through the first phase were validated by conducting another 50 structured interviews. RESULTS: Major domains developed were perceptions on STI, the source of information, treatment seeking behavior, understanding of treatment, laboratory test, and follow-up. Friends and counselor played an important role as the source of right information, while elder family female played a role in delayed seeking care. CONCLUSION: Developed domains can be used to assess STI clinic attendee's perspective on STI. Poor understanding of STI care component especially prevention, partner treatment, and referral was noted after the clinic visit.
RESUMEN
Healthy environment for children initiating an alliance for action (WHO) has reported that over 40% of the global burden of disease attributed to environmental risk factors fall on children below 5 years of age, who account for about 10% of the world's population. That is why to look into the new area of concern, this cross sectional study was carried out to explore the influence of domestic environment over the illness of under five children.