The role of health facilities in promoting male partner support in elimination of mother-to-child transmission of HIV in Mbale District
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Involving men in Elimination of Mother-to-Child Transmission (EMTCT) of Human Immunodeficiency Virus (HIV) is now part of national and international policy guidelines. However, there is limited documentation of what constitutes the role of health facilities. The purpose of the study examine how the health delivery systems, health service providers, health infrastructure and resource utilization both financial and logistical influence male partner support in EMTCT of HIV. A descriptive and analytical research design using qualitative approach was carried out among respondents in 9 Health Centre levels III and IV. The study population comprised of; health service providers, Health Centre in-charges, key informantsand men as secondary respondents. Data was collected using unstructured in-depth interviews, semi-structured with observation checklist. The study involved a sample of 36 health service provider respondents, 7 KIs, and 3 Focus group Discussions (FGDs) that were selected using purposive and convenience sampling methods respectively.Thematic and content analysis was adopted to categorize the qualitative data and to establish patterns along the study objectives. From the findings, it is evident that health delivery systems are not ready for male partner support at HealthCenters. This is reflected by; understaffing which leads to workload, lack of funds to carry out EMTCT activities. More still there are no specific activities designed to directly involve men in EMTCT. Health workers also lack necessary and required skills and trainings in handling men. As a result, they are unable to educate and tactfully mobilize men to appreciate the initiative. Inadequate infrastructural facilities evidenced in aspects like; lack of adequate space and buildings with designated and equipped rooms for EMTCT. If men were to turn up in large numbers as expected with their expectant spouses, thehealth units would be heavily overwhelmed, and at a loss of what to do with them.Ante-natal care (ANC) points are still largely designed for women. Government and other policy implementers should increase funding, improve the infrastructure and logistics at health units.In addition, arrangements should be made to train health workers in aspects of male partner support.The key lesson / conclusion from this study is that it is not enough to place focus on male partners, an implicit way of placing blame on clients for any failures of a program. Equal, if not more attention should instead be targeted towards the supply side of EMTCT services to make the services attractive to the male partners.