One of the greatest challenges facing Prevention of Mother-to-Child Transmission of HIV (PMTCT) services is reaching sexual partners of HIV-positive women and persuading them to receive HIV counseling and testing .and getting them involved in PMTCT services.
Traditionally, sexual and reproductive health (SHR) services that include PMTCT have focused mostly on Women, yet many observers have emphasized that the knowledge, attitudes, behaviors and health of men often play a critical role in determining the reproductive health of women.
There is strong evidence that excluding men in Reproductive health increase vulnerability of women of HIV compromise the effectiveness of HIV prevention strategies and create barriers to effective HIV treatment. Men play a major role in reproductive health decisions in Uganda. Thus addressing male involvement can contribute to improved uptake PMTCT services.
Basing on UNHCO’s intervention “improving maternal health services and utilization of PMTCT services through the rights based approach” involving men is particularly challenging whose culturally defined roles hinder men’s participation. For example where communication between couples is limited and manifestation often involve violence. One mother had this to say “if I do not breastfeed everyone will know I have HIV. What do I say to my husband?”
Other challenges faced is reproductive health is usually considered a women’s concern both within the household and policy level, unfriendly health facilities, unsuitable timing for the men who always say are too busy, health worker attitudes to men, men fearing to know their status, and lack of a family approach towards maternal health service delivery.
In Implementation of the project UNHCO is in agreement that it is difficult to have men involved in PMTCT. This is attributed by a number of challenges that included;
- The attitude of men towards maternal health services
- men wanted privacy while seeking PMTCT services
- peer pressure whereby men who attended maternal health services were considered weak
- The women considered themselves to be strong that didn’t want the men’s involvement.
The success of the PMTCT partner involvement can be attributed to activities which should include a community-provider partnership approach that promotes partner involvement by challenging attitudes and behaviors of men that compromise their own health as well as the health of women and children. This can be done by community dialogues meetings. And for those that do not attend the community meetings, more effective means such as home visits and following up men to their popular hangouts can be used In order to reach out to the men
Other recommendations that are used by UNHCO are identification of couples that can be used as mentors and role models to encourage there fellow men to get involved in PMTCT services. Such couples were given first priority in receiving PMTCT services at the health facilities but issue of favoritism and discrimination was brought up thus discouraging it.
Other issues that were considered by the community dialogue meetings was the issue of changing PMTCT focus from the mother to both parents. In other words changing the name PMTCT to P(P) TCT where P stands for parent. This could help in bringing more men on board
These Interventions are supported by Cordaid.