Evidence map›Paper›PMID 33858394›Full record

ArticleBMC health services research2021

Integrated early childhood development services improve mothers' experiences with prevention of mother to child transmission (PMTCT) programs in Malawi: a qualitative study.

Kathryn Dovel, Pericles Kalande, Evelyn Udedi, Tijana Temelkovska, Julie Hubbard, Chipariro Mbalanga, Laurie Bruns, Siyenunu Mulungu, Sundeep Gupta, Linda Richter and 1 more

Abstract read
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kathryn DovelPartners in Hope, Lilongwe, Malawi. kdovel@mednet.ucla.edu.ORCID http://orcid.org/0000-0002-5622-3401
Pericles KalandePartners in Hope, Lilongwe, Malawi.
Evelyn UdediPartners in Hope, Lilongwe, Malawi.
Tijana TemelkovskaDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
Julie HubbardDivision of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Chipariro MbalangaPartners in Hope, Lilongwe, Malawi.
Laurie BrunsDivision of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Siyenunu MulunguPartners in Hope, Lilongwe, Malawi.
Sundeep GuptaPartners in Hope, Lilongwe, Malawi.
Linda RichterDSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
Thomas J CoatesDivision of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

Funding

Virology CoreP30AI028697 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JAMIESON-KARAVODIN, BETH DEIRDRE · 1991 to 2018
$39.9M
Innovative strategies to increase ART Initiation and viral suppression among HIV+ men in MalawiK01TW011484 · FIC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DOVEL, KATHRYN L · 2019 to 2023
$717k
Conrad N. Hilton Foundation 17248FIC NIH HHS K01 TW011484FIC NIH HHS K01TW011484NIAID NIH HHS P30 AI028697University of California, Los Angeles CFAR AI028697
6 · The paper itself

Abstract

backgroundHIV-positive mothers who face the dual burden of HIV-positive status and motherhood, may benefit from holistic services that include early childhood development (ECD). We evaluated the acceptability and impact of integrated ECD-PMTCT interventions for mothers and their children.

methodsWe implemented an integrated ECD-PMTCT intervention in 4 health facilities in Malawi for HIV-positive mothers and their infants. WHO/UNICEF Care for Child Development (CCD) education and counseling sessions were offered during routine PMTCT visits between infant age 1.5-24 months. From June-July 2019, we conducted in-depth interviews with 29 mothers enrolled in the intervention for ≥6 months across 4 health facilities. The interview guide focused on perceived impact of the intervention on mothers' ECD and PMTCT practices, including barriers and facilitators, and unmet needs related to the program. Data were coded and analyzed using constant comparison methods in Atlas ti.8.

resultsThe vast majority of mothers believed the ECD-PMTCT intervention improved their overall experience with the PMTCT services, strengthened their relationship with providers, and excited and motivated them to attend PMTCT services during the postpartum period. Unlike prior experience, mothers felt more welcome at the health facility, and looked forward to the next visit in order to interact with other mothers and learn new ECD skills. Mothers formed new social support networks with other mothers engaged in ECD sessions, and they provided emotional and financial support to one another, including encouragement regarding ART adherence. Mothers believed their infants reached developmental milestones faster compared to non-intervention children they observed at the same age, and they experienced improved engagement in caregiving activities among male caregivers. Nearly half of women requested additional support with depression or anxiety, coping mechanisms to deal with the stresses of life, or support in building positive dynamics with their male partner.

conclusionThe integrated ECD-PMTCT intervention improved mother's experiences with PMTCT programs and health care providers, increased ECD practices such as responsive and stimulating parenting, and created social support networks for women with other PMTCT clients.

Indexed as

HIV InfectionsPregnancy Complications, InfectiousChildChild DevelopmentChild, PreschoolFemaleHumansInfantInfectious Disease Transmission, VerticalMalawiMaleMothersPregnancy

Identifiers

PMID33858394
PMCPMC8048322

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.