Title : Gap analysis of ANC and PNC for women living with HIV in 6 districts in Indonesia
Abstract:
Background: Women living with HIV face stigma and discrimination in obtaining health services. Not only those related to HIV services (screening, testing, ARV treatment and viral load monitoring) but also maternal ANC (antenatal care), delivery and PNC (postnatal) services, as well as postnatal contraception. On the other hand, some HIV positive women may also be key populations with risky sexual behavior or injecting narcotic users (IDUs). The low bargaining position of housewives causes the inability to access affordable health services and behave in a preventive and protective manner. Looking at the facts above, it cannot be denied that HIV positive women face many challenges to maintain their level of health so that they can still play an optimal role in their social environment.
Objectives: The objective of this study is to describe the situation of women living with HIV in Indonesia and provide policy recommendations.
Method: This study will be conducted using a mixed method. Qualitative research is carried out at the first phase to explore the current factual situation and the expected ideal conditions. Meanwhile, quantitative research was carried out in the second phase to prove the relationship between factors that contribute to the health status of HIV positive women.
Result: the qualitative study found that stigma and discrimination are the primary barrier of health service accessibility of women living with HIV. Other contributions to the Absence of health insurance has led women living with HIV to out of pocket pay for the service while on the other side, limited primary health care facilities have capacity to provide childbearing services and postnatal care for women living with HIV. Due to stigma and discrimination, some informants have hidden their HIV status to the health personnel. For the ANC, the services are relatively similar with other women due standard of quality care, while for the postpartum contraception, breastmilk feeding and pediatric prophylaxis are very rarely advised.
Recommendation: a policy gap is identified on the PMTCT (prevention of mother to child transmission) program implementation that includes regulating the ARV that low risk to anemia, whether TT immunization was allowed, affordable postpartum contraception method and breastmilk counseling and ARV prophylaxis for pediatric.
